Urogenital Tract Infection

Original Articles

The Korean Antimicrobial Resistance Monitoring System for Complicated Urinary Tract Infections: A Prospective Multicenter Observational Study Conducted by the Korean Association of Urogenital Tract Infection and Inflammation: Seong Hyeon Yu, Seung Il Jung, Donghoon Lim, Jeong Woo Lee, Seung-Ju Lee, Hong Chung, Mi-Mi Oh, Jing Bong Choi, Jae Hung Jung, Hee Jo Yang, KAUTII Investigators; Urogenit Tract Infect 2026;21(1):15-25. Published online April 30, 2026; DOI: https://doi.org/10.14777/uti.2550040020

Abstract PDF PubReader: Purpose
This study aimed to report antimicrobial resistance (AMR) patterns among patients with complicated urinary tract infection (cUTI) using data from the Korean Antimicrobial Resistance Monitoring System (KARMS). Materials and Methods: In this prospective, multicenter, observational surveillance study, data from patients diagnosed with cUTI between January 2023 and September 2025 were retrieved from the KARMS database. Demographic characteristics, uropathogen distribution, and antimicrobial susceptibility profiles of representative pathogens were analyzed.
Results
Data from a total of 698 patients were collected in the KARMS database. The mean patient age was 68.94±15.95 years. The numbers of patients with healthcare-associated UTI and recurrent UTI were 171 (24.5%) and 240 (34.4%), respectively. Escherichia coli was the most frequently identified uropathogen (n=356, 51.1%). Regarding antimicrobial susceptibility, 92.9% of isolates were susceptible to fosfomycin, 75.5% to nitrofurantoin, 47.2% to ciprofloxacin, 63.3% to cefotaxime, 80.6% to piperacillin/tazobactam, and 98.8% to ertapenem. The rate of extended-spectrum beta-lactamase positivity was 45.2% (166 of 367) and was significantly higher in pyelonephritis and urosepsis (62.3% and 62.5%, p=0.002), healthcare-associated UTI (58.6%, p=0.040), and recurrent cUTI (53.2%, p=0.028). Fluoroquinolone resistance was significantly more common in female patients (49.1%, p=0.021) and in healthcare-associated UTI (57.9%, p=0.014). Piperacillin/tazobactam resistance was significantly higher in patients with urosepsis (37.0%, p=0.004), in tertiary hospitals (17.2%, p=0.019), and in healthcare-associated UTI (26.4%, p=0.001). In addition, third-generation cephalosporin resistance was significantly higher in secondary hospitals than in tertiary hospitals (43.5% vs. 33.3%, p=0.041).
Conclusions
These data provide current information on uropathogen distribution and AMR patterns in cUTI in South Korea. Continued surveillance and ongoing data accumulation through KARMS will support evidence-based strategies for optimal antimicrobial therapy and AMR mitigation.

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Characteristics and Treatment Trends for Emphysematous Pyelonephritis in Korea: A 10-Year Multicenter Retrospective Study: Seung-Kwon Choi, Koo Han Yoo, Jeong Woo Lee, Seung Il Jung, Eu Chang Hwang, Joongwon Choi, Woong Bin Kim, Jung Sik Huh, Jin Bong Choi, Yeonjoo Kim, Jae Min Chung, Ju-Hyun Shin, Jae Hung Jung, Hong Chung, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2021;16(2):49-54. Published online August 31, 2021; DOI: https://doi.org/10.14777/uti.2021.16.2.49

Abstract PDF PubReader ePub: Purpose: This study examined the characteristics, current treatment trends, and outcomes of patients with emphysematous pyelonephritis (EPN) in Korea.
Materials andMethods: Two hundred and seventeen patients diagnosed with EPN were evaluated using abdominal computed tomography in 2011-2021 at 15 institutes in Korea. The patients’ demographic and clinical characteristics, treatment modalities, and treatment outcomes were analyzed. The total study period was divided arbitrarily into groups A (2011-2014), B (2015-2017), and C (2018-2021) to analyze the trends in the EPN treatment.
Results: The mean age of the patients was 65.1 years; there were more female patients (74.2%) than male patients. The overall mortality rate was 10.6%. Ninety-five (43.8%), 98 (45.2%), and 24 (11.0%) patients were treated with medical, minimally invasive, and surgical management, respectively; the corresponding mortality rates were 13.7%, 6.1%, and 16.7%. There was no significant change in the proportion of patients treated with medical management over time (group A=46.5%, group B=47.0%, and group C=38.8%). The proportion of patients treated with minimally invasive management gradually increased over time (group A=35.2%; group B=43.9%; group C=55.0%), while those who underwent surgical management decreased gradually over time (group A=18.3%, group B=9.1%, and group C=6.3%). No differences in mortality rates were observed between the groups.
Conclusions: EPN with medical and minimally invasive management had a relatively high treatment success rate, which increased gradually, while surgical management decreased gradually over time in Korea. The mortality rate was relatively lower than that reported in studies published before the 2010s.

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