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Increasing burden of biliary tract infection caused by extended-spectrum beta-lactamase-producing organisms in Korea: A nationwide population-based study
- Title
- Increasing burden of biliary tract infection caused by extended-spectrum beta-lactamase-producing organisms in Korea: A nationwide population-based study
- Authors
- Jang, Dong Kee; Kim, Jungmee; Park, Wan Beom; Yi, Sun Young; Lee, Jun Kyu; Yoon, Won Jae
- Ewha Authors
- 이선영; 윤원재
- SCOPUS Author ID
- 이선영; 윤원재
- Issue Date
- 2020
- Journal Title
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
- ISSN
- 0815-9319
1440-1746
- Citation
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY vol. 35, no. 1, pp. 56 - 64
- Keywords
- biliary tract diseases; cholangitis; cholecystitis; extended-spectrum beta-lactamase
- Publisher
- WILEY
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background and Aim Biliary tract infections (BTIs) are a major cause of bacteremia. The prevalence of antibiotic-resistant pathogens in BTI patients is reported to be increasing. We used a nationwide database to evaluate the prevalence of, and risk factors for, BTIs caused by extended-spectrum beta-lactamase-producing organisms (ESBL-PO) in Korea. Methods Patients with a BTI diagnosis, an admission history, a history of a BTI-related procedure, and antibiotic use for >= 4 days between 2007 and 2016 were identified from the Health Insurance Review and Assessment Service database. A BTI treated with carbapenems (BTI-TC) was used as the surrogate for a BTI caused by ESBL-PO. We conducted a multivariate logistic regression analysis to determine the risk factors for BTI-TC. Results In total, 341 002 patients were enrolled. The overall percentage of BTI-TC among BTIs was 2.4%, with an increasing annual trend (P < 0.0001). The risk of acute cholangitis caused by ESBL-PO increased significantly in men, older patients, patients with comorbidities, patients with a history of a biliary procedure within the previous year, and patients with a history of antibiotic use within the previous 90 days. Regarding antibiotic use, the patients at highest risk were those previously prescribed carbapenems (adjusted odds ratio, 4.77; P < 0.0001). Conclusions The prevalence of BTIs caused by ESBL-PO has increased during the last 10 years. Initial carbapenem therapy should be considered for elderly patients with acute cholangitis if they have had a previous biliary procedure and/or a history of carbapenem administration within the previous 90 days.
- DOI
- 10.1111/jgh.14809
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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