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Clinical characteristics of community-acquired acute pyelonephritis caused by ESBL-producing pathogens in South Korea

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Author(s)
B. KimJ. KimM.-R. SeoS.-H. WieY. K. ChoS.-K. LimJ. S. LeeK. T. KwonH. LeeH. J. CheongD. W. ParkS. Y. RyuM.-H. ChungM. KiH. Pai
Keimyung Author(s)
Ryu, Seong Yeol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Infection
Issued Date
2013
Volume
41
Issue
3
Abstract
Objectives The aim of this study was to determine the risk
factors and clinical characteristics of community-acquired
acute pyelonephritis (CA-APN) caused by extended-spectrum
b-lactamase (ESBL)-producing organisms.
Methods From March 2010 to February 2011, patients
with CA-APN were recruited in 11 hospitals in South
Korea. Clinical and microbiological data were collected
prospectively, and the ESBLs and multilocus sequence
types of the ESBL-producing Escherichia coli were
characterized. Comparison between CA-APN caused by
ESBL-producing Enterobacteriaceae and those by non-
ESBL-producing organisms was performed.
Results A total of 566 patients were recruited. Enterobacteriaceae
were detected in 526 patients. Forty-six isolates
(46/526, 8.7 %) were positive for ESBLs. Clinical and
microbiological failure did not differ between the two
groups, despite there being fewer patients with ESBLpositive
isolates provided with appropriate antibiotics initially
(19.6 vs. 93.8 %, p\0.001). However, the duration
of hospitalization was longer in the ESBL group (10.5 vs.
7.0 days, p = 0.012). In a logistic regression model,
Charlson score C1 point [odds ratio (OR) 3.4, 95 % confidence
interval (CI) 1.6–7.0, p = 0.001], antibiotics usage
during the previous year (OR 3.1, 95 % CI 1.4–7.2,
p = 0.008), and urinary catheterization during the previous
month (OR 4.4, 95 % CI 1.1–17.6, p = 0.035) were
associated with the risks of CA-APN by ESBL producers.
CTX-M-15 (48 %) and CTX-M-14 (38 %) were the most
Keimyung Author(s)(Kor)
류성열
Publisher
School of Medicine
Citation
B. Kim et al. (2013). Clinical characteristics of community-acquired acute
pyelonephritis caused by ESBL-producing pathogens
in South Korea. Infection, 41(3), 603–612. doi: 10.1007/s15010-013-0441-z
Type
Article
ISSN
0300-8126
Source
http://lps3.link.springer.com.proxy.dsmc.or.kr/article/10.1007%2Fs15010-013-0441-z
DOI
10.1007/s15010-013-0441-z
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35864
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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