Antibiogram of Multidrug-Resistant Bacteria Based on Sepsis Onset Location in Korea : A Multicenter Cohort Study
© 2023 The Korean Academy of Medical Sciences..
BACKGROUND: Administration of adequate antibiotics is crucial for better outcomes in sepsis. Because no uniform tool can accurately assess the risk of multidrug-resistant (MDR) pathogens, a local antibiogram is necessary. We aimed to describe the antibiogram of MDR bacteria based on locations of sepsis onset in South Korea.
METHODS: We performed a prospective observational study of adult patients diagnosed with sepsis according to Sepsis-3 from 19 institutions (13 tertiary referral and 6 university-affiliated general hospitals) in South Korea. Patients were divided into four groups based on the respective location of sepsis onset: community, nursing home, long-term-care hospital, and hospital. Along with the antibiogram, risk factors of MDR bacteria and drug-bug match of empirical antibiotics were analyzed.
RESULTS: MDR bacteria were detected in 1,596 (22.7%) of 7,024 patients with gram-negative predominance. MDR gram-negative bacteria were more commonly detected in long-term-care hospital- (30.4%) and nursing home-acquired (26.3%) sepsis, whereas MDR gram-positive bacteria were more prevalent in hospital-acquired (10.9%) sepsis. Such findings were consistent regardless of the location and tier of hospitals throughout South Korea. Patients with long-term-care hospital-acquired sepsis had the highest risk of MDR pathogen, which was even higher than those with hospital-acquired sepsis (adjusted odds ratio, 1.42; 95% confidence interval, 1.15-1.75) after adjustment of risk factors. The drug-bug match was lowest in patients with long-term-care hospital-acquired sepsis (66.8%).
CONCLUSION: Gram-negative MDR bacteria were more common in nursing home- and long-term-care hospital-acquired sepsis, whereas gram-positive MDR bacteria were more common in hospital-acquired settings in South Korea. Patients with long-term-care hospital-acquired sepsis had the highest the risk of MDR bacteria but lowest drug-bug match of initial antibiotics. We suggest that initial antibiotics be carefully selected according to the onset location in each patient.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
|---|---|
| Enthalten in: |
Journal of Korean medical science - 38(2023), 10 vom: 13. März, Seite e75 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kim, Hyung-Jun [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 16.03.2023 Date Revised 17.03.2023 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.3346/jkms.2023.38.e75 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM354235796 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM354235796 | ||
| 003 | DE-627 | ||
| 005 | 20231226061758.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3346/jkms.2023.38.e75 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1180.xml |
| 035 | |a (DE-627)NLM354235796 | ||
| 035 | |a (NLM)36918029 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kim, Hyung-Jun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antibiogram of Multidrug-Resistant Bacteria Based on Sepsis Onset Location in Korea |b A Multicenter Cohort Study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.03.2023 | ||
| 500 | |a Date Revised 17.03.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Korean Academy of Medical Sciences. | ||
| 520 | |a BACKGROUND: Administration of adequate antibiotics is crucial for better outcomes in sepsis. Because no uniform tool can accurately assess the risk of multidrug-resistant (MDR) pathogens, a local antibiogram is necessary. We aimed to describe the antibiogram of MDR bacteria based on locations of sepsis onset in South Korea | ||
| 520 | |a METHODS: We performed a prospective observational study of adult patients diagnosed with sepsis according to Sepsis-3 from 19 institutions (13 tertiary referral and 6 university-affiliated general hospitals) in South Korea. Patients were divided into four groups based on the respective location of sepsis onset: community, nursing home, long-term-care hospital, and hospital. Along with the antibiogram, risk factors of MDR bacteria and drug-bug match of empirical antibiotics were analyzed | ||
| 520 | |a RESULTS: MDR bacteria were detected in 1,596 (22.7%) of 7,024 patients with gram-negative predominance. MDR gram-negative bacteria were more commonly detected in long-term-care hospital- (30.4%) and nursing home-acquired (26.3%) sepsis, whereas MDR gram-positive bacteria were more prevalent in hospital-acquired (10.9%) sepsis. Such findings were consistent regardless of the location and tier of hospitals throughout South Korea. Patients with long-term-care hospital-acquired sepsis had the highest risk of MDR pathogen, which was even higher than those with hospital-acquired sepsis (adjusted odds ratio, 1.42; 95% confidence interval, 1.15-1.75) after adjustment of risk factors. The drug-bug match was lowest in patients with long-term-care hospital-acquired sepsis (66.8%) | ||
| 520 | |a CONCLUSION: Gram-negative MDR bacteria were more common in nursing home- and long-term-care hospital-acquired sepsis, whereas gram-positive MDR bacteria were more common in hospital-acquired settings in South Korea. Patients with long-term-care hospital-acquired sepsis had the highest the risk of MDR bacteria but lowest drug-bug match of initial antibiotics. We suggest that initial antibiotics be carefully selected according to the onset location in each patient | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Drug Resistance, Multiple, Bacterial | |
| 650 | 4 | |a Epidemiologic Studies | |
| 650 | 4 | |a Nursing homes | |
| 650 | 4 | |a Sepsis | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Oh, Dong Kyu |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Sung Yoon |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Young-Jae |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Sunghoon |e verfasserin |4 aut | |
| 700 | 1 | |a Suh, Gee Young |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Chae-Man |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Yeon Joo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of Korean medical science |d 1995 |g 38(2023), 10 vom: 13. März, Seite e75 |w (DE-627)NLM012649317 |x 1598-6357 |7 nnns |
| 773 | 1 | 8 | |g volume:38 |g year:2023 |g number:10 |g day:13 |g month:03 |g pages:e75 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3346/jkms.2023.38.e75 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 38 |j 2023 |e 10 |b 13 |c 03 |h e75 | ||