Luncheon Symposium 23【Sysmex】

Antimicrobial resistance (AMR) has been major concern worldwide. According to Japanese nationwide surveillance carried out in 2020, progression of AMR was observed not only among complicated urinary tract infections (cUTIs) but also among uncomplicated UTIs (uUTIs); Among cUTIs, Fluoroquinolone (FQ)-resistant Escherichia coli (E. coli) and Extended-spectrum β-lactamase (ESBL)-producing E. coli ranged to 44.5% and 24.8%, respectively. Among uUTIs, FQ-resistant E. coli and ESBL-producing E. coli accounted for 20.0% and 10.6%, respectively. Additionally, in postmenopausal women with uUTIs, higher rates of FQ-resistant and ESBL-producing E. coli were observed than in premenopausal women.  
The JAID/JSC Guide to Clinical Management of Infectious Diseases 2023, published by Japanese Association for Infectious Diseases (JAID) and Japanese Society of Chemotherapy (JSC), was revised from the previous edition published in 2019. In the section of UTIs, for patients with cystitis and pyelonephritis (non-catheterized cases), recommended antimicrobial regimens were revised according to isolated bacteria; The grade of recommendations for oral FQs and oral third-generation cephalosporins have decreased, and oral penicillins and first-generation cephalosporins have tended to be recommended at high grade. Recommendations for cases in which ESBL-producing strains are suspected or isolated have been set as an independent item for each infection, and oral and intravenous antimicrobials other than carbapenems are recommended. Moreover, urinary flow cytometry method (uFCM) is introduced as a useful modality. UF-1500 and UF-5000 (Sysmex Corporation, Kobe, Japan) are fully automated urine sediment analyzer to assess urine components. They can provide significant information for clinicians to diagnose UTIs and identify bacteria. Especially regarding bacterial profile, bacteria can be determined to be gram-positive or negative, and it can provide the results of drug susceptibility testing within only 1 hour.  
 The presentation will provide an overview of surveillance data, treatment guidelines and advanced examinations, which can help clinicians to select appropriate antimicrobials in the era of highly progressive AMR.