Kwon Ki Tae, Kim Bongyoung, Ryu Seong-Yeol, Wie Seong-Heon, Kim Jieun, Jo Hyun-Uk, Park Se Yoon, Hong Kyung-Wook, Kim Hye In, Kim Hyun Ah, Kim Mi-Hee, Bae Mi Hyun, Sohn Yong-Hak, Kim Jieun, Lee Yangsoon, Pai Hyunjoo
Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41566, Korea.
Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.
Antibiotics (Basel). 2020 Sep 18;9(9):617. doi: 10.3390/antibiotics9090617.
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. was the most common causative pathogen of CA-APN in both periods (87.3% vs. 86.5%, = 0.680). isolates showed significantly higher antimicrobial resistance against fluoroquinolone (32.0% vs. 21.6%, < 0.001), cefotaxime (33.6% vs. 8.3%, < 0.001), and trimethoprim/sulfamethoxazole (37.5% vs. 29.2%, = 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 ( < 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 ( < 0.001). The median hospitalization was higher for patients in 2017-2018 than in 2010-2011 (9 vs. 7 days, < 0.001). In conclusion, antimicrobial resistance of 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.
本研究调查了2010 - 2011年至2017 - 2018年期间韩国社区获得性急性肾盂肾炎（CA - APN）临床特征的变化。我们前瞻性地招募了2017年9月至2018年8月期间在韩国8家医院就诊的所有年龄≥19岁的CA - APN患者。收集的数据与2010 - 2012年的先前研究数据进行比较，先前研究设计相同，有11家医院参与。共纳入617例患者，并与2010 - 2011年收集的818例患者的数据进行比较。在两个时期，[具体病原体未给出]都是CA - APN最常见的致病病原体（87.3%对86.5%，P = 0.680）。2017 - 2018年，[具体病原体未给出]分离株对氟喹诺酮类（32.0%对21.6%，P < 0.001）、头孢噻肟（33.6%对8.3%，P < 0.001）和甲氧苄啶/磺胺甲恶唑（37.5%对29.2%，P = 0.013）的耐药性显著高于2010 - 2011年。抗生素治疗总时长从2010 - 2011年的16.55±9.68天增加到2017 - 2018年的19.12±9.90天（P < 0.001）；碳青霉烯类药物使用时长从2010 - 2011年的0.59±2.87天增加到2010 - 2011年的1.79±4.89天（P < 0.001）。2017 - 2018年患者的住院中位数高于2010 - 2011年（9天对7天，P < 0.001）。总之，在韩国CA - APN中，[具体病原体未给出]对几乎所有抗生素类别，尤其是第三代头孢菌素的耐药性显著增加。因此，包括碳青霉烯类药物使用在内的抗生素治疗总时长增加。
