266
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Sat-425￭
Etiology of pyogenic vertebral osteomyelitis according to demographic and clinical characteristics.
1서울대학교병원 감염내과, 2전남대학교병원 감염내과, 3분당서울대학교병원 감염내과
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김동연
1, 김어진
2, 유요한
2, 김성은
2, 강승지
2, 전강일
1, 강창경
1, 문송미
3, 송경호
3, 김의석
3, 김홍빈
3, 장희창
2, 정숙인
2, 오명돈
1, 박경화
2, 김남중
1 Background/Aims: Microbiologic diagnosis is important in the management of pyogenic vertebral osteomyelitis (PVO). Etiologic microorganisms of PVO have been reported several times, but distribution of microorganisms according to age, sex, involving spine levels, and underlying diseases were not reported before. The aim of this study is to show distribution of etiologic microorganisms of PVO according to demographic and clinical characteristics.Methods: We retrospectively reviewed the medical records of patients with culture-proven PVO between Jan 2005 and Dec 2015. Patients were included when etiologic microorganisms were identified from spine/paraspinal tissues or blood. We excluded patients who had remnant prosthesis at the time of di- agnosis of VO or had spine operation within 1 year of the diagnosis of PVO. Results: A total of 450 patients with culture-proven PVO were investigated.
The most common etiologic microorganism was Staphylococcus aureus regardless of age, sex, involved spines, and underling diseases. S. aureus was more common in patients aged 60 yrs old or less (53.9% in < 60 yr, 44.1% in 60-75 yr, 39.0% in > 75 yr, p<0.05), and gram-negative bacteria were more common in patients aged 60 yrs or more, but difference was not significant (14.2% in < 60 yr vs. 20.7% in 60 - 75 yr, 26.8% in > 75 yr, p=0.065). Gram-negative bacteria were more common in women compared with men (29.4% in women vs. 14.3% in men, p<0.05).
Distribution of etiologic microorganism was not different according to involving spine levels, and underlying diseases except predominance of methicillin-resistant S. aureus (MRSA) in patients with chronic kidney disease(CKD). Gram-negative bacteria were more common in patients with liver cirrhosis(LC) than in those without liver diseases, but differ- ence was not significant (27.9% in patients with LC vs. 18.9% in patients without LC, p=0.159). Conclusions: S. aureus was more common in pa- tients aged 60 yrs old or less. Gram-negative bacteria tend to be more common in patients aged 60 yrs old or more, and women. Distribution of etiologic microorganisms was not different according to involving spine levels and underlying diseases except predominance of MRSA in patients with CKD.
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Sat-426￭
Is carbapenem-sparing therapy as effective as carbapenems against ESBL Enterobacteriaceae in UTI ?
연세의대 신촌세브란스병원
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현종훈, 손유진, 조윤숙, 이용섭, 안상민, 이운지, 김정호, 성혜, 안진영, 구남수, 최준용, 염준섭, 정수진
Background/Aims: With the emergence of carbapenem-resistant strains of Enterobacteriaceae, non-carbapenem antibiotics are suggested as the alter- native treatment of extended-spectrum beta-lactamase(ESBL) producing Enterobacteriaceae infection. In this study, efficacy of non-carbapenem antibiotics on acute pyelonephritis (APN) with ESBL-producing Enterobacteriaceae was compared to that of carbapenems. Methods: The medical records of patients who had diagnosed to have acute pyelonephritis with ESBL-producing Enterobacteriaceae on their urine culture, from January 2011 to December 2018, were reviewed retrospectively. Patients were classified as carbapenem and non-carbapenem group according to the definitive antibiotics they had treated with. Results: Total number of patients was 141, including 112 (79.4%) who had received carbapenem, and 29 (20.6%) received non-carbapenem as defin- itive therapy against to APN with ESBL-producing Enterobacteriaceae. The duration of hospitalization was shorter for non-carbapenem group (median 9.93 days) than for carbapenem group (median 14.39 days) (p<0.001). The duration of negative conversion of culture was shorter for carbapenem group (median 40.73 hours) than for non-carbapenem group (median 56.79 hours) There was no significant difference in time to febrile period and duration of definitive therapy between two groups. Conclusions: Non-carbapenem therapy against APN with ESBL-producing enterobacteriaceae has no significant difference in clinical outcome compared to carbapenem therapy.
