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논문 기본 정보

자료유형
학술저널
저자정보
Kim Hyung-Jun (Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Korea.) Oh Dong Kyu (Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea.) Lim Sung Yoon (Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Korea.) Cho Young-Jae (Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Korea.) Park Sunghoon (Department of Pulmonary Allergy and Critical Care Medicine Hallym University Sacred Heart Hospital Anyang Korea.) Suh Gee Young (Division of Pulmonary and Critical Care Medicine Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Lim Chae-Man (Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea.) Lee Yeon Joo (Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.10
발행연도
2023.3
수록면
1 - 20 (20page)
DOI
10.3346/jkms.2023.38.e75

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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 universityaffiliated 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-termcare hospital- (30.4%) and nursing home-acquired (26.3%) sepsis, whereas MDR grampositive 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 hospitalacquired 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.

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