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Etiology, Characteristics, and Outcomes of Community-Onset Pyomyositis in Korea: A Multicenter Study

Infection & Chemotherapy 2021년 53권 1호 p.46 ~ 52
김탁, 박성연, 곽이경, 정지원, 김민철, 최성호, 유시내, 홍효림, 김용균, 박세윤, 송은희, 박기호, 조오현, 최상호,
소속 상세정보
김탁 ( Kim Tark ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
박성연 ( Park Seong-Yeon ) - Dongguk University Ilsan Hospital Department of Internal Medicine
곽이경 ( Kwak Yee-Gyung ) - Inje University Ilsan Paik Hospital Department of Internal Medicine
정지원 ( Jung Ji-Won ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
김민철 ( Kim Min-Chul ) - Chung-Ang University Hospital Department of Internal Medicine
최성호 ( Choi Seong-Ho ) - Chung-Ang University Hospital Department of Internal Medicine
유시내 ( Yu Shi-Nae ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
홍효림 ( Hong Hyo-Lim ) - Daegu Catholic University Medical Center Department of Internal Medicine
김용균 ( Kim Yong-Kyun ) - Hallym University College of Medicine Hallym University Sacred Heart Hospital Department of Internal Medicine
박세윤 ( Park Se-Yoon ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
송은희 ( Song Eun-Hee ) - Gangneung Asan Hospital Department of Internal Medicine
박기호 ( Park Ki-Ho ) - Kyung Hee University School of Medicine Kyung Hee University Hospital Department of Internal Medicine
조오현 ( Cho Oh-Hyun ) - Gyeongsang National University Changwon Hospital Department of Internal Medicine
최상호 ( Choi Sang-Ho ) - University of Ulsan College of Medicine Asan Medical Center Department of Infectious Diseases

Abstract


Background: Pyomyositis (PM) is a serious soft tissue infection and despite its clinical importance, previous studies have not been able to fully determine the clinical characteristics and microbial epidemiology of PM in Korea, which we therefore aimed to investigate.

Materials and Methods: We retrospectively identified 140 adult patients diagnosed with PM from 13 general hospitals between January 2012 and December 2015. We analyzed the clinical and microbial characteristics of community-onset PM and compared them with community-acquired (CA) and healthcare-associated (HCA) PM.

Results: One hundred eleven organisms were isolated from 96 (68.6%) patients with PM. Staphylococcus aureus (38 patients) was the most common pathogen, followed by streptococci (24 patients), and enteric Gram-negative organisms (27 patients). Methicillin-resistant S. aureus (MRSA) was identified in four (2.9%) patients and in-hospital mortality reached 8.6% (12/140). Enterococci isolates were identified in the HCA PM subgroup only The proportion of MRSA isolates was not comparable between CA and HCA PM subgroups. In the 83 patients with PM infected by monomicrobial pathogens, isolates of Gram-negative organisms were more commonly found in HCA PM subgroup than in CA PM subgroup (47.6% [10/21] of patients with HCA PM vs. 20.7% [12/58] of patients with CA PM; P = 0.01).

Conclusion: Gram-positive cocci such as S. aureus and streptococci were dominant etiologies in community-onset PM, whereas MRSA appears to an uncommon causative organism of PM in Korea. Enteric Gram-negative organisms should also be considered as major etiologies, especially in HCA PM patient population in Korea.

키워드

Pyomyositis; Community; Etiology

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