Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia
Background/Aims The aim of this study was to compare antimicrobial resistance, clinical features, and outcomes of community-onset Escherichia coli (COEC) and Klebsiella pneumoniae (COKP) bacteremia. Methods The medical records of patients diagnosed with E. coli or K. pneumoniae bacteremia in the eme...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Association of Internal Medicine
2021-03-01
|
| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://www.kjim.org/upload/pdf/kjim-2019-272.pdf |
| _version_ | 1831789956862836736 |
|---|---|
| author | Hwa Seok Sung Je Won Lee Sohyun Bae Ki Tae Kwon |
| author_facet | Hwa Seok Sung Je Won Lee Sohyun Bae Ki Tae Kwon |
| author_sort | Hwa Seok Sung |
| collection | DOAJ |
| description | Background/Aims The aim of this study was to compare antimicrobial resistance, clinical features, and outcomes of community-onset Escherichia coli (COEC) and Klebsiella pneumoniae (COKP) bacteremia. Methods The medical records of patients diagnosed with E. coli or K. pneumoniae bacteremia in the emergency department of a 750-bed secondary care hospital in Daegu, Korea from January 2010 to December 2016 were retrospectively reviewed. Results A total of 866 patients with COEC bacteremia and 299 with COKP bacteremia were enrolled. COEC bacteremia, compared to COKP bacteremia, had higher rates of 3rd generation cephalosporin (3GC) (18.8% vs. 8.4%, p < 0.001) and f luoroquinolone (FQ) (30.4% vs. 8.0%, p < 0.001) resistance. The patients with COKP bacteremia had higher Charlson comorbidity indices (CCI) (1.8 ± 2.0 vs. 1.5 ± 1.8, p = 0.035), Pittsburgh bacteremia scores (PBS) (2.0 ± 2.6 vs. 1.3 ± 1.8, p < 0.001), and 30-day mortality (14.44% vs. 8.8%, p = 0.008) than the patients with COEC bacteremia. Age younger than 70 years, male sex, polymicrobial infections, pneumonia, intra-abdominal infection, PBS ≥ 2, and Foley catheter insertion were independent predictive factors for COKP bacteremia compared to COEC bacteremia in the multivariate analysis. CCI, PBS, and intensive care unit admission were independent risk factors for 30-day mortality in the multivariate analysis. Conclusions 3GCs and FQs are still useful for the empirical treatment of patients with probable COKP bacteremia. The patients with COKP bacteremia had worse outcomes because of its greater severity and more frequent underlying comorbidities. |
| first_indexed | 2024-12-22T14:20:46Z |
| format | Article |
| id | doaj.art-2e19263b600644c3bf86912830c9d9ab |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-22T14:20:46Z |
| publishDate | 2021-03-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-2e19263b600644c3bf86912830c9d9ab2022-12-21T18:22:59ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482021-03-0136243344010.3904/kjim.2019.272170337Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremiaHwa Seok Sung0Je Won Lee1Sohyun Bae2Ki Tae Kwon3 Department of Emergency Medicine, Daegu Fatima Hospital, Daegu, Korea Department of Emergency Medicine, Daegu Fatima Hospital, Daegu, Korea Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, KoreaBackground/Aims The aim of this study was to compare antimicrobial resistance, clinical features, and outcomes of community-onset Escherichia coli (COEC) and Klebsiella pneumoniae (COKP) bacteremia. Methods The medical records of patients diagnosed with E. coli or K. pneumoniae bacteremia in the emergency department of a 750-bed secondary care hospital in Daegu, Korea from January 2010 to December 2016 were retrospectively reviewed. Results A total of 866 patients with COEC bacteremia and 299 with COKP bacteremia were enrolled. COEC bacteremia, compared to COKP bacteremia, had higher rates of 3rd generation cephalosporin (3GC) (18.8% vs. 8.4%, p < 0.001) and f luoroquinolone (FQ) (30.4% vs. 8.0%, p < 0.001) resistance. The patients with COKP bacteremia had higher Charlson comorbidity indices (CCI) (1.8 ± 2.0 vs. 1.5 ± 1.8, p = 0.035), Pittsburgh bacteremia scores (PBS) (2.0 ± 2.6 vs. 1.3 ± 1.8, p < 0.001), and 30-day mortality (14.44% vs. 8.8%, p = 0.008) than the patients with COEC bacteremia. Age younger than 70 years, male sex, polymicrobial infections, pneumonia, intra-abdominal infection, PBS ≥ 2, and Foley catheter insertion were independent predictive factors for COKP bacteremia compared to COEC bacteremia in the multivariate analysis. CCI, PBS, and intensive care unit admission were independent risk factors for 30-day mortality in the multivariate analysis. Conclusions 3GCs and FQs are still useful for the empirical treatment of patients with probable COKP bacteremia. The patients with COKP bacteremia had worse outcomes because of its greater severity and more frequent underlying comorbidities.http://www.kjim.org/upload/pdf/kjim-2019-272.pdfcephalosporinsquinolonecomorbiditymortality |
| spellingShingle | Hwa Seok Sung Je Won Lee Sohyun Bae Ki Tae Kwon Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia The Korean Journal of Internal Medicine cephalosporins quinolone comorbidity mortality |
| title | Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia |
| title_full | Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia |
| title_fullStr | Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia |
| title_full_unstemmed | Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia |
| title_short | Comparison of antimicrobial resistances and clinical features in community-onset Escherichia coli and Klebsiella pneumoniae bacteremia |
| title_sort | comparison of antimicrobial resistances and clinical features in community onset escherichia coli and klebsiella pneumoniae bacteremia |
| topic | cephalosporins quinolone comorbidity mortality |
| url | http://www.kjim.org/upload/pdf/kjim-2019-272.pdf |
| work_keys_str_mv | AT hwaseoksung comparisonofantimicrobialresistancesandclinicalfeaturesincommunityonsetescherichiacoliandklebsiellapneumoniaebacteremia AT jewonlee comparisonofantimicrobialresistancesandclinicalfeaturesincommunityonsetescherichiacoliandklebsiellapneumoniaebacteremia AT sohyunbae comparisonofantimicrobialresistancesandclinicalfeaturesincommunityonsetescherichiacoliandklebsiellapneumoniaebacteremia AT kitaekwon comparisonofantimicrobialresistancesandclinicalfeaturesincommunityonsetescherichiacoliandklebsiellapneumoniaebacteremia |