Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data

Yongseop Lee; Young Ah Kim; Dokyun Kim; Jong Hee Shin; Young Uh; Kyeong Seob Shin; Jeong Hwan Shin; Seok Hoon Jeong; Yoon Soo Park

doi:10.1016/j.ijantimicag.2019.09.005

Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data

Yongseop Lee, Young Ah Kim, Dokyun Kim, Jong Hee Shin, Young Uh, Kyeong Seob Shin, Jeong Hwan Shin, Seok Hoon Jeong, Yoon Soo Park

Department of Laboratory Medicine

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Background: Although it is essential to know the particular causes of antibiotic-resistant infections in the community, there is lack of evidence regarding risk factors for community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) bacteraemia in South Korea. As such, this study aimed to identify risk factors for community-onset ESBL-KP bacteraemia. Methods: From May 2016 to April 2017, patients with community-onset KP bloodstream infection (BSI) (n = 408) from six sentinel hospitals participating in the Global Antimicrobial Surveillance System in South Korea were included in this study. Risk factors of ESBL-KP BSI were assessed. Polymerase chain reaction and sequencing to identify genes encoding ESBLs and multi-locus sequence typing were performed. Results: Of the 408 patients with community-onset KP BSI, 70 (17%) had ESBL-KP BSI. Admission to a long-term-care hospital within the previous 3 months [odds ratio (OR) 5.7, 95% confidence interval (CI) 2.1–15.6; P = 0.001], previous use of trimethoprim/sulfamethoxazole (TMP/SMT; OR 11.5, 95% CI 2.7–48.6; P = 0.001) or extended-spectrum cephalosporin (OR 2.2, 95% CI 1.2–3.9; P = 0.01), and previous use of a urinary catheter (OR 2.3, 95% CI 1.1–4.5; P = 0.02) were independent risk factors for community-onset ESBL-KP BSI. ESBL-KP isolates most frequently carried the CTX-M-1 group ESBL (74%, n = 52). The most prevalent sequence type (ST) among the ESBL-KP isolates was ST48 (14%, n = 10). Among non-ESBL-KP isolates, ST23 was most prevalent (21%, n = 70). Conclusion: Previous admission to a long-term-care hospital, use of a urinary catheter and use of TMP/SMT or extended-spectrum cephalosporin within the previous 3 months were identified as risk factors for community-onset ESBL-KP BSI. Strict antibiotic stewardship and infection control measures are needed for long-term-care hospitals.

Original language	English
Pages (from-to)	723-727
Number of pages	5
Journal	International Journal of Antimicrobial Agents
Volume	54
Issue number	6
DOIs	https://doi.org/10.1016/j.ijantimicag.2019.09.005
Publication status	Published - 2019 Dec

Bibliographical note

Funding Information:
The authors wish to thank all Kor-GLASS participants for their contribution to the programme. Funding: This work was supported by the research programmes funded by the Korea Centers for Disease Control and Prevention (2017E280401#, PI: Y.S.P; 2017E4400100#, PI: S.H.J). Competing interests: None declared. Ethical approval: This study was approved by the local ethics committees of all local institutional review boards of the sentinel hospitals.

Publisher Copyright:
© 2019 Elsevier Ltd

All Science Journal Classification (ASJC) codes

Microbiology (medical)
Infectious Diseases
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijantimicag.2019.09.005

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Lee, Y., Kim, Y. A., Kim, D., Shin, J. H., Uh, Y., Shin, K. S., Shin, J. H., Jeong, S. H., & Park, Y. S. (2019). Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data. International Journal of Antimicrobial Agents, 54(6), 723-727. https://doi.org/10.1016/j.ijantimicag.2019.09.005

@article{770c3c2c9df849d5b54ab57cf9215b29,

title = "Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data",

abstract = "Background: Although it is essential to know the particular causes of antibiotic-resistant infections in the community, there is lack of evidence regarding risk factors for community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) bacteraemia in South Korea. As such, this study aimed to identify risk factors for community-onset ESBL-KP bacteraemia. Methods: From May 2016 to April 2017, patients with community-onset KP bloodstream infection (BSI) (n = 408) from six sentinel hospitals participating in the Global Antimicrobial Surveillance System in South Korea were included in this study. Risk factors of ESBL-KP BSI were assessed. Polymerase chain reaction and sequencing to identify genes encoding ESBLs and multi-locus sequence typing were performed. Results: Of the 408 patients with community-onset KP BSI, 70 (17%) had ESBL-KP BSI. Admission to a long-term-care hospital within the previous 3 months [odds ratio (OR) 5.7, 95% confidence interval (CI) 2.1–15.6; P = 0.001], previous use of trimethoprim/sulfamethoxazole (TMP/SMT; OR 11.5, 95% CI 2.7–48.6; P = 0.001) or extended-spectrum cephalosporin (OR 2.2, 95% CI 1.2–3.9; P = 0.01), and previous use of a urinary catheter (OR 2.3, 95% CI 1.1–4.5; P = 0.02) were independent risk factors for community-onset ESBL-KP BSI. ESBL-KP isolates most frequently carried the CTX-M-1 group ESBL (74%, n = 52). The most prevalent sequence type (ST) among the ESBL-KP isolates was ST48 (14%, n = 10). Among non-ESBL-KP isolates, ST23 was most prevalent (21%, n = 70). Conclusion: Previous admission to a long-term-care hospital, use of a urinary catheter and use of TMP/SMT or extended-spectrum cephalosporin within the previous 3 months were identified as risk factors for community-onset ESBL-KP BSI. Strict antibiotic stewardship and infection control measures are needed for long-term-care hospitals.",

author = "Yongseop Lee and Kim, {Young Ah} and Dokyun Kim and Shin, {Jong Hee} and Young Uh and Shin, {Kyeong Seob} and Shin, {Jeong Hwan} and Jeong, {Seok Hoon} and Park, {Yoon Soo}",

note = "Funding Information: The authors wish to thank all Kor-GLASS participants for their contribution to the programme. Funding: This work was supported by the research programmes funded by the Korea Centers for Disease Control and Prevention (2017E280401#, PI: Y.S.P; 2017E4400100#, PI: S.H.J). Competing interests: None declared. Ethical approval: This study was approved by the local ethics committees of all local institutional review boards of the sentinel hospitals. Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd",

year = "2019",

month = dec,

doi = "10.1016/j.ijantimicag.2019.09.005",

language = "English",

volume = "54",

pages = "723--727",

journal = "International Journal of Antimicrobial Agents",

issn = "0924-8579",

publisher = "Elsevier",

number = "6",

}

Lee, Y, Kim, YA, Kim, D, Shin, JH, Uh, Y, Shin, KS, Shin, JH, Jeong, SH & Park, YS 2019, 'Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data', International Journal of Antimicrobial Agents, vol. 54, no. 6, pp. 723-727. https://doi.org/10.1016/j.ijantimicag.2019.09.005

Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data. / Lee, Yongseop; Kim, Young Ah; Kim, Dokyun et al.
In: International Journal of Antimicrobial Agents, Vol. 54, No. 6, 12.2019, p. 723-727.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data

AU - Lee, Yongseop

AU - Kim, Young Ah

AU - Kim, Dokyun

AU - Shin, Jong Hee

AU - Uh, Young

AU - Shin, Kyeong Seob

AU - Shin, Jeong Hwan

AU - Jeong, Seok Hoon

AU - Park, Yoon Soo

N1 - Funding Information: The authors wish to thank all Kor-GLASS participants for their contribution to the programme. Funding: This work was supported by the research programmes funded by the Korea Centers for Disease Control and Prevention (2017E280401#, PI: Y.S.P; 2017E4400100#, PI: S.H.J). Competing interests: None declared. Ethical approval: This study was approved by the local ethics committees of all local institutional review boards of the sentinel hospitals. Publisher Copyright: © 2019 Elsevier Ltd

PY - 2019/12

Y1 - 2019/12

N2 - Background: Although it is essential to know the particular causes of antibiotic-resistant infections in the community, there is lack of evidence regarding risk factors for community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) bacteraemia in South Korea. As such, this study aimed to identify risk factors for community-onset ESBL-KP bacteraemia. Methods: From May 2016 to April 2017, patients with community-onset KP bloodstream infection (BSI) (n = 408) from six sentinel hospitals participating in the Global Antimicrobial Surveillance System in South Korea were included in this study. Risk factors of ESBL-KP BSI were assessed. Polymerase chain reaction and sequencing to identify genes encoding ESBLs and multi-locus sequence typing were performed. Results: Of the 408 patients with community-onset KP BSI, 70 (17%) had ESBL-KP BSI. Admission to a long-term-care hospital within the previous 3 months [odds ratio (OR) 5.7, 95% confidence interval (CI) 2.1–15.6; P = 0.001], previous use of trimethoprim/sulfamethoxazole (TMP/SMT; OR 11.5, 95% CI 2.7–48.6; P = 0.001) or extended-spectrum cephalosporin (OR 2.2, 95% CI 1.2–3.9; P = 0.01), and previous use of a urinary catheter (OR 2.3, 95% CI 1.1–4.5; P = 0.02) were independent risk factors for community-onset ESBL-KP BSI. ESBL-KP isolates most frequently carried the CTX-M-1 group ESBL (74%, n = 52). The most prevalent sequence type (ST) among the ESBL-KP isolates was ST48 (14%, n = 10). Among non-ESBL-KP isolates, ST23 was most prevalent (21%, n = 70). Conclusion: Previous admission to a long-term-care hospital, use of a urinary catheter and use of TMP/SMT or extended-spectrum cephalosporin within the previous 3 months were identified as risk factors for community-onset ESBL-KP BSI. Strict antibiotic stewardship and infection control measures are needed for long-term-care hospitals.

AB - Background: Although it is essential to know the particular causes of antibiotic-resistant infections in the community, there is lack of evidence regarding risk factors for community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) bacteraemia in South Korea. As such, this study aimed to identify risk factors for community-onset ESBL-KP bacteraemia. Methods: From May 2016 to April 2017, patients with community-onset KP bloodstream infection (BSI) (n = 408) from six sentinel hospitals participating in the Global Antimicrobial Surveillance System in South Korea were included in this study. Risk factors of ESBL-KP BSI were assessed. Polymerase chain reaction and sequencing to identify genes encoding ESBLs and multi-locus sequence typing were performed. Results: Of the 408 patients with community-onset KP BSI, 70 (17%) had ESBL-KP BSI. Admission to a long-term-care hospital within the previous 3 months [odds ratio (OR) 5.7, 95% confidence interval (CI) 2.1–15.6; P = 0.001], previous use of trimethoprim/sulfamethoxazole (TMP/SMT; OR 11.5, 95% CI 2.7–48.6; P = 0.001) or extended-spectrum cephalosporin (OR 2.2, 95% CI 1.2–3.9; P = 0.01), and previous use of a urinary catheter (OR 2.3, 95% CI 1.1–4.5; P = 0.02) were independent risk factors for community-onset ESBL-KP BSI. ESBL-KP isolates most frequently carried the CTX-M-1 group ESBL (74%, n = 52). The most prevalent sequence type (ST) among the ESBL-KP isolates was ST48 (14%, n = 10). Among non-ESBL-KP isolates, ST23 was most prevalent (21%, n = 70). Conclusion: Previous admission to a long-term-care hospital, use of a urinary catheter and use of TMP/SMT or extended-spectrum cephalosporin within the previous 3 months were identified as risk factors for community-onset ESBL-KP BSI. Strict antibiotic stewardship and infection control measures are needed for long-term-care hospitals.

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Risk factors of community-onset extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteraemia in South Korea using national health insurance claims data

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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