Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic <i>Escherichia coli</i> in South Korea in the Past Decade

• Main Authors: Ki Tae Kwon (Author), Bongyoung Kim (Author), Seong-yeol Ryu (Author), Seong-Heon Wie (Author), Jieun Kim (Author), Hyun-uk Jo (Author), Se Yoon Park (Author), Kyung-Wook Hong (Author), Hye In Kim (Author), Hyun ah Kim (Author), Mi-Hee Kim (Author), Mi Hyun Bae (Author), Yong-Hak Sohn (Author), Yangsoon Lee (Author), Hyunjoo Pai (Author)
• Format: Book
• Published: MDPI AG, 2020-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

This study examined changes in the clinical characteristics of community-acquired acute pyelonephritis (CA-APN) in South Korea between the period 2010-2011 and 2017-2018. We recruited all CA-APN patients aged ≥19 years who visited eight hospitals in South Korea from September 2017 to August 2018, prospectively. Data collected were compared with those from the previous study in 2010-2012, with the same design and participation from 11 hospitals. A total of 617 patients were enrolled and compared to 818 patients' data collected in 2010-2011. <i>Escherichia coli</i> was the most common causative pathogen of CA-APN in both periods (87.3% vs. 86.5%, <i>p</i> = 0.680). <i>E. coli</i> isolates showed significantly higher antimicrobial resistance against fluoroquinolone (32.0% vs. 21.6%, <i>p</i> < 0.001), cefotaxime (33.6% vs. 8.3%, <i>p</i> < 0.001), and trimethoprim/sulfamethoxazole (37.5% vs. 29.2%, <i>p</i> = 0.013) in 2017-2018 than in 2010-2011. Total duration of antibiotic treatment increased from 16.55 ± 9.68 days in 2010-2011 to 19.12 ± 9.90 days in 2017-2018 (<i>p</i> < 0.001); the duration of carbapenem usage increased from 0.59 ± 2.87 days in 2010-2011 to 1.79 ± 4.89 days in 2010-2011 (<i>p</i> < 0.001). The median hospitalization was higher for patients in 2017-2018 than in 2010-2011 (9 vs. 7 days, <i>p</i> < 0.001). In conclusion, antimicrobial resistance of <i>E. coli</i> to almost all antibiotic classes, especially third generation cephalosporin, increased significantly in CA-APN in South Korea. Consequently, total duration of antibiotic treatment, including carbapenem usage, increased.

Item Description

10.3390/antibiotics9090617
2079-6382