Comparison of Escherichia coli and Klebsiella pneumoniae Acute Pyelonephritis in Korean Patients
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Background: Escherichia coli and Klebsiella pneumoniae are two of the most common causes of urinary tract infection. The purpose of this study was to compare clinical characteristics and antimicrobial susceptibility of acute pyelonephritis (APN) between E. coli and K. pneumoniae. Materials and Methods: We retrospectively reviewed medical records of patients with APN due to E. coli and K. pneumoniae between February 2014 and October 2017. Results: A total 329 patients were enrolled; 258 cases of E. coli and 71 cases of K. pneumoniae. Among them, 219 cases were categorized into community-onset APN; 194 cases of E. coli and 25 cases of K. pneumoniae, and 110 patients were categorized into healthcare-associated APN; 64 cases of E. coli and 46 cases of K. pneumoniae. Catheter-associated APN was more frequently observed in K. pneumoniae in both community-onset and healthcare-associated APN. Neurogenic bladder, obstructive uropathy, urinary tract stone, bacteremia, and severe APN were more related to E. coli in healthcare-associated APN. In multivariate analysis, urinary catheter was more associated with K. pneumoniae (odds ratio [OR] 9.643, 95% confidence intervals [CI] 4.919-18.904, P = 0.001) and neurogenic bladder was more associated with E. coli (OR 3.765, 95% CI 1.112-12.772, P = 0.033). Extended-spectrum β-lactamase (ESBL) production was observed in 29.0% of E. coli in community-onset APN. Among ESBL, antimicrobial susceptibility of piperacillin/tazobactam was significantly higher in E. coli and ciprofloxacin was significantly higher in K. pneumoniae. Conclusion: K. pneumoniae were more associated with urinary catheter while E. coli tended to be more associated with urogenital problems. ESBL positivity showed no significance in healthcare-associated APN. In community-onset APN, ESBL producing E. coli was more observed than K. pneumoniae.
Abstract
Background: Escherichia coli and Klebsiella pneumoniae are two of the most common causes of urinary tract infection. The purpose of this study was to compare clinical characteristics and antimicrobial susceptibility of acute pyelonephritis (APN) between E. coli and K. pneumoniae. Materials and Methods: We retrospectively reviewed medical records of patients with APN due to E. coli and K. pneumoniae between February 2014 and October 2017. Results: A total 329 patients were enrolled; 258 cases of E. coli and 71 cases of K. pneumoniae. Among them, 219 cases were categorized into community-onset APN; 194 cases of E. coli and 25 cases of K. pneumoniae, and 110 patients were categorized into healthcare-associated APN; 64 cases of E. coli and 46 cases of K. pneumoniae. Catheter-associated APN was more frequently observed in K. pneumoniae in both community-onset and healthcare-associated APN. Neurogenic bladder, obstructive uropathy, urinary tract stone, bacteremia, and severe APN were more related to E. coli in healthcare-associated APN. In multivariate analysis, urinary catheter was more associated with K. pneumoniae (odds ratio [OR] 9.643, 95% confidence intervals [CI] 4.919-18.904, P = 0.001) and neurogenic bladder was more associated with E. coli (OR 3.765, 95% CI 1.112-12.772, P = 0.033). Extended-spectrum β-lactamase (ESBL) production was observed in 29.0% of E. coli in community-onset APN. Among ESBL, antimicrobial susceptibility of piperacillin/tazobactam was significantly higher in E. coli and ciprofloxacin was significantly higher in K. pneumoniae. Conclusion: K. pneumoniae were more associated with urinary catheter while E. coli tended to be more associated with urogenital problems. ESBL positivity showed no significance in healthcare-associated APN. In community-onset APN, ESBL producing E. coli was more observed than K. pneumoniae.
참고문헌 (34)
- Flores-Mireles AL, "Urinary tract infections: epidemiology, mechanisms of infection and treatment options", Nat Rev Microbiol, 13, pp.269~284 (2015)
- Magill SS, "Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida", Infect Control Hosp Epidemiol, 33, pp.283~291 (2012)
- Ali S, "Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia : longitudinal study", Antimicrob Resist Infect Control, 7, pp.2~ (2018)
- Allegranzi B, "Burden of endemic health-care-associated infection in developing countries : systematic review and meta-analysis", Lancet, 377, pp.228~241 (2011)
- Wagenlehner FM, "Epidemiology, treatment and prevention of healthcare-associated urinary tract infections", World J Urol, 30, pp.59~67 (2012)
- Vásquez V, "Urinary tract infections in inpatients: that challenge", Rev Esp Quimioter, 30(Suppl 1), pp.39~41 (2017)
- Oh WS, "Factors associated with specific uropathogens in catheter-associated urinary tract infection : developing a clinical prediction model", J Int Med Res, 42, pp.1335~1347 (2014)
- Kang CI, "Clinical significance of nosocomial acquisition in urinary tract-related bacteremia caused by gramnegative bacilli", Am J Infect Control, 39, pp.135~140 (2011)
- Chiang CH, "Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: recent trends based on national surveillance reports", Antimicrob Resist Infect Control, 7, pp.129~ (2018)
- Olesen B, "A comparative study of nosocomial and community-acquired strains of Escherichia coli causing bacteraemia in a Danish University Hospital", J Hosp Infect, 31, pp.295~304 (1995)
- Tsay RW, "Characteristics of bacteremia between community-acquired and nosocomial Klebsiella pneumoniae infection : risk factor for mortality and the impact of capsular serotypes as a herald for community-acquired infection", Arch Intern Med, 162, pp.1021~1027 (2002)
- Kreger BE, "Gram-negative bacteremia. III. Reassessment of etiology, epidemiology and ecology in 612 patients", Am J Med, 68, pp.332~343 (1980)
- Haque R, "Prevalence and susceptibility of uropathogens : a recent report from a teaching hospital in Bangladesh", BMC Res Notes, 8, pp.416~ (2015)
- Ranjan Dash N, "Community-acquired urinary tract infections due to extended-spectrum β-lactamase-producing organisms in United Arab Emirates", Travel Med Infect Dis, 22, pp.46~50 (2018)
- Kunin CM, "Definition of acute pyelonephritis vs the urosepsis syndrome", Arch Intern Med, 163, pp.2393~ (2003)
- McCabe WR, "Gram-negative bacteremia.I. Etiology and ecology", Arch Intern Med, 110, pp.847~855 (1962)
- Clinical and Laboratory Standards Institute (CLSI), "M100-S25 performance standards for antimicrobial susceptibility testing; Twenty-fifth informational supplement", CLSI, ~ (2015)
- Uslan DZ, "Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota", Arch Intern Med, 167, pp.834~839 (2007)
- Baizet C, "Decreased antibiotic susceptibility of Enterobacteriaceae causing community-acquired urinary tract infections in French Amazonia", Med Mal Infect, 49, pp.63~68 (2019)
- Johansen TE, "Hospital acquired urinary tract infections in urology departments: pathogens, susceptibility and use of antibiotics. Data from the PEP and PEAP-studies", Int J Antimicrob Agents, 28(Suppl 1), pp.S91~S107 (2006)
- Chen SC, "Comparison of Escherichia coli and Klebsiella pneumoniae liver abscesses", Am J Med Sci, 334, pp.97~105 (2007)
- Maharjan G, "Catheter-associated urinary tract infection and obstinate biofilm producers", Can J Infect Dis Med Microbiol, 2018, pp.7624857~ (2018)
- Stickler D, "Studies on the formation of crystalline bacterial biofilms on urethral catheters", Eur J Clin Microbiol Infect Dis, 17, pp.649~652 (1998)
- Mulvey MA, "Induction and evasion of host defenses by type 1-piliated uropathogenic Escherichia coli", Science, 282, pp.1494~1497 (1998)
- Mittal S, "Biofilm and multidrug resistance in uropathogenic Escherichia coli", Pathog Glob Health, 109, pp.26~29 (2015)
- Bo-Ram Kim, "The Relation between Postvoid Residual and Occurrence of Urinary Tract Infection after Stroke in Rehabilitation Unit", Annals of Rehabilitation Medicine, 36(2), pp.248~253 (2012), 대한재활의학회[DOI]
- McKibben MJ, "Urinary tract infection and neurogenic bladder", Urol Clin North Am, 42, pp.527~536 (2015)
- Hickling DR, "Anatomy and physiology of the urinary tract: relation to host defense and microbial infection", Microbiol Spectr, 3 (2015)
- Chen D, "The analysis of microbial spectrum and antibiotic resistance of uropathogens isolated from patients with urinary stones", Int J Clin Pract, 72, pp.e13205~ (2018)
- Megged O, "Bacteremic vs nonbacteremic urinary tract infection in children", Am J Emerg Med, 35, pp.36~38 (2017)
- Oh WS, "Developing a model to estimate the probability of bacteremia in women with community-onset febrile urinary tract infection", J Infect Dev Ctries, 10, pp.1222~1229 (2016)
- Devrim F, "The emerging resistance in nosocomial urinary tract infections: from the pediatrics perspective", Mediterr J Hematol Infect Dis, 10, pp.e2018055~ (2018)
- Peleg AY, "Hospital-acquired infections due to gram-negative bacteria", N Engl J Med, 362, pp.1804~1813 (2010)
- Scheuerman O, "Comparison of predictors and mortality between bloodstream infections caused by ESBL-producing Escherichia coli and ESBL-producing Klebsiella pneumoniae", Infect Control Hosp Epidemiol, 39, pp.660~667 (2018)