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Article

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

1
Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41566, Korea
2
Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
3
Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu 41931, Korea
4
Division of Infectious Diseases, Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
5
Department of Urology, School of Medicine, Eulji University, Daejeon 34824, Korea
6
Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea
7
Division of Infectious Diseases, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju 52727, Korea
8
Department of Internal Meidcine, Daegu Fatima Hospital, Daegu 41199, Korea
9
Department of Laboratory Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
10
Seegene Medical Foundation, Seoul 04805, Korea
11
Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea
*
Authors to whom correspondence should be addressed.
Received: 27 August 2020 / Revised: 10 September 2020 / Accepted: 17 September 2020 / Published: 18 September 2020
(This article belongs to the Special Issue Antimicrobial Resistance: The Final Frontier)
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. Escherichia coli was the most common causative pathogen of CA-APN in both periods (87.3% vs. 86.5%, p = 0.680). E. coli isolates showed significantly higher antimicrobial resistance against fluoroquinolone (32.0% vs. 21.6%, p < 0.001), cefotaxime (33.6% vs. 8.3%, p < 0.001), and trimethoprim/sulfamethoxazole (37.5% vs. 29.2%, p = 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 (p < 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 (p < 0.001). The median hospitalization was higher for patients in 2017–2018 than in 2010–2011 (9 vs. 7 days, p < 0.001). In conclusion, antimicrobial resistance of E. coli 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. View Full-Text
Keywords: pyelonephritis; urinary tract infection; antimicrobial resistance; Korea pyelonephritis; urinary tract infection; antimicrobial resistance; Korea
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MDPI and ACS Style

Kwon, K.T.; Kim, B.; Ryu, S.-y.; Wie, S.-H.; Kim, J.; Jo, H.-u.; Park, S.Y.; Hong, K.-W.; Kim, H.I.; Kim, H.a.; Kim, M.-H.; Bae, M.H.; Sohn, Y.-H.; Kim, J.; Lee, Y.; Pai, H. Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade. Antibiotics 2020, 9, 617. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9090617

AMA Style

Kwon KT, Kim B, Ryu S-y, Wie S-H, Kim J, Jo H-u, Park SY, Hong K-W, Kim HI, Kim Ha, Kim M-H, Bae MH, Sohn Y-H, Kim J, Lee Y, Pai H. Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade. Antibiotics. 2020; 9(9):617. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9090617

Chicago/Turabian Style

Kwon, Ki T., Bongyoung Kim, Seong-yeol Ryu, Seong-Heon Wie, Jieun Kim, Hyun-uk Jo, Se Y. Park, Kyung-Wook Hong, Hye I. Kim, Hyun a. Kim, Mi-Hee Kim, Mi H. Bae, Yong-Hak Sohn, Jieun Kim, Yangsoon Lee, and Hyunjoo Pai. 2020. "Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade" Antibiotics 9, no. 9: 617. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9090617

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