Volume 25, Number 1—January 2019
Research
Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea
Min Hyuk Choi, Myungsook Kim, Su Jin Jeong, Jun Yong Choi1
, In-Yong Lee, Tai-Soon Yong, Dongeun Yong, Seok Hoon Jeong, and Kyungwon Lee1
, In-Yong Lee, Tai-Soon Yong, Dongeun Yong, Seok Hoon Jeong, and Kyungwon Lee1
Table 2
Baseline characteristics of patients in a tertiary teaching hospital who acquired Elizabethkingia and differences before and after 2016, Seoul, South Korea*
| Characteristic | Total, n = 269 | 2009–2015, n = 135 | 2016–June 2017, n = 134 | p value | |
|---|---|---|---|---|---|
| Median age, y (range) |
64.0 (47.0–74.0) |
65.0 (46.0–73.0) |
63.0 (47.0–74.0) |
0.67 |
|
| Sex, no. (%) | 0.24 | ||||
| M | 165 (61.3) | 88 (65.2) | 77 (57.5) | ||
| F |
104 (38.7) |
47 (34.8) |
57 (42.5) |
||
| Nosocomial infection, no. (%) |
254 (94.4) |
122 (90.4) |
132 (98.5) |
0.01 |
|
| Median Charlson comorbidity index (range) |
5.0 (3.0–7.0) |
5.0 (3.0–7.0) |
5.0 (4.0–7.0) |
0.04 |
|
| Comorbidities, no. (%)† | |||||
| Solid-organ tumor | 86 (32.0) | 46 (34.1) | 40 (29.9) | 0.54 | |
| Diabetes mellitus | 74 (27.5) | 28 (20.7) | 46 (34.3) | 0.02 | |
| Chronic pulmonary disease | 70 (26.0) | 18 (13.3) | 52 (38.8) | <0.01 | |
| Chronic kidney disease | 54 (20.1) | 22 (16.3) | 32 (23.9) | 0.16 | |
| Hemiplegia | 37 (13.8) | 14 (10.4) | 23 (17.2) | 0.15 | |
| Hematologic malignancy | 33 (12.3) | 15 (11.1) | 18 (13.4) | 0.69 | |
| Cerebrovascular disease | 31 (11.5) | 12 (8.9) | 19 (14.2) | 0.24 | |
| Dementia | 28 (10.4) | 12 (8.9) | 16 (11.9) | 0.54 | |
| Connective tissue disease | 23 (8.6) | 13 (9.6) | 10 (7.5) | 0.68 | |
| Mild liver disease |
13 (4.8) |
6 (4.4) |
7 (5.2) |
0.99 |
|
| Clinical conditions | |||||
| Median hospitalization day of acquisition (range) | 33.0 (17.0–69 .0) | 28.0 (14.0–55.5) | 36.0 (18.0–75.0) | 0.02 | |
| Median length of hospitalization, d (range) | 69.0 (39.0–133.0) | 59.0 (35.0–99.5) | 78.0 (41.0–149.0) | 0.04 | |
| Mechanical ventilation, no. (%) | 214 (79.6) | 99 (73.3) | 115 (85.8) | 0.02 | |
| Steroid use, no. (%) | 161 (59.9) | 72 (53.3) | 89 (66.4) | 0.04 | |
| Prior ICU stay, no. (%) |
142 (52.8) |
73 (54.1) |
69 (51.5) |
0.76 |
|
| Sample type, no. (%)† | |||||
| Respiratory | 219 (81.4) | 95 (70.4) | 124 (92.5) | <0.01 | |
| Blood culture | 19 (7.1) | 12 (8.9) | 7 (5.2) | 0.35 | |
| Urine culture | 14 (5.2) | 13 (9.6) | 1 (0.7) | <0.01 | |
| Other |
23 (8.6) |
16 (11.9) |
7 (5.2) |
0.08 |
|
| Infection sign or symptom, no. (%) | |||||
| Pneumonia | 23 (8.6) | 9 (6.7) | 14 (10.4) | 0.37 | |
| Sepsis | 12 (4.5) | 7 (5.2) | 5 (3.7) | 0.78 | |
| Polymicrobial infection |
221 (82.2) |
110 (81.5) |
111 (82.8) |
0.90 |
|
| Laboratory finding‡ | |||||
| Leukocyte count, 109 cells/L (range) | 8.2 (5.9–11.8) | 8.2 (6.2–12.5) | 7.8 (5.9–11.1) | 0.52 | |
| Hemoglobin concentration, g/dL (range) | 9.5 (8.4–10.5) | 9.8 (8.8–11.0) | 9.0 (8.1–10.2) | <0.01 | |
| Platelet count, 109/L (range) | 169.5 (82.0–268.0) | 161.0 (84.0–263.5) | 170.5 (80.0–271.0) | 0.48 | |
| Erythrocyte sedimentation rate, mm/h (range) | 49.0 (16.0–79.0) | 52.0 (14.0–85.0) | 39.5 (17.5–74.0) | 0.28 | |
| Total bilirubin, mg/dL (range) | 0.6 (0.3–1.4) | 0.7 (0.4–1.6) | 0.5 (0.3–1.2) | 0.04 | |
| Serum creatinine, ng/mL (range) | 0.6 (0.4–1.1) | 0.6 (0.4–1.1) | 0.6 (0.4–1.1) | 0.78 | |
| C-reactive protein, mg/L (range) |
51.4 (20.2–85.0) |
63.6 (30.7–93.9) |
35.2 (15.2–76.0) |
<0.01 |
|
| 14-d mortality, no. (%) | 32 (11.9) | 20 (14.8) | 12 (9.0) | 0.20 | |
| In-hospital mortality, no. (%) |
95 (35.3) |
56 (41.5) |
39 (29.1) |
0.05 |
|
| Location, no. (%) | <0.01 | ||||
| Ward A | 27 (10.0) | 3 (2.2) | 24 (34.3) | ||
| Ward B | 39 (14.5) | 3 (2.2) | 36 (22.4) | ||
| ICU 1 | 19 (7.1) | 5 (3.7) | 14 (26.1) | ||
| ICU 2 | 3 (1.1) | 3 (2.2) | 0 | ||
| ICU 3 | 10 (3.7) | 6 (4.4) | 4 (3) | ||
| Emergency department | 8 (3) | 8 (5.9) | 0 | ||
| ICU 4 | 4 (1.5) | 2 (1.5) | 2 (1.5) | ||
| ICU 5 | 36 (13.4) | 21 (15.6) | 15 (11.2) | ||
| ICU 6 | 33 (12.3) | 20 (14.8) | 13 (9.7) | ||
| ICU 7 | 9 (3.3) | 5 (3.7) | 4 (3) | ||
| ICU 8 | 5 (1.9) | 4 (3) | 1 (0.7) | ||
| NICU 1 | 15 (5.6) | 7 (5.2) | 8 (6) | ||
| NICU 2 | 1 (0.4) | 0 | 1 (0.7) | ||
| Other |
60 (22.3) |
48 (35.6) |
12 (9.0) |
||
| Antimicrobial drug exposure, no. (%) | |||||
| Penicillin§ | 26 (9.7) | 12 (8.9) | 14 (10.4) | 0.82 | |
| 1st-generation cephalosporin | 17 (6.3) | 8 (5.9) | 9 (6.7) | 0.99 | |
| 2nd-generation cephalosporin | 19 (7.1) | 10 (7.4) | 9 (6.7) | 0.99 | |
| 3rd-generation cephalosporin | 77 (28.6) | 42 (31.1) | 35 (26.1) | 0.44 | |
| 4th-generation cephalosporin | 37 (13.8) | 14 (10.4) | 23 (17.2) | 0.15 | |
| Aminoglycoside | 25 (9.3) | 12 (8.9) | 13 (9.7) | 0.98 | |
| Glycopeptide | 106 (39.4) | 52 (38.5) | 54 (40.3) | 0.86 | |
| Linezolid | 11 (4.1) | 8 (5.9) | 3 (2.2) | 0.22 | |
| Carbapenem | 57 (21.2) | 30 (22.2) | 27 (20.1) | 0.79 | |
| Tetracycline | 12 (4.5) | 6 (4.4) | 6 (4.5) | 0.99 | |
| Colistin | 7 2.6) | 7 (5.2) | 0 | 0.02 | |
| Trimethoprim–sulfamethoxazole | 32 (11.9) | 20 (14.8) | 12 (9.0) | 0.20 | |
| Lincosamide | 17 (6.3) | 8 (5.9) | 9 (6.7) | 0.99 | |
| Macrolide | 16 (5.9) | 10 (7.4) | 6 (4.5) | 0.45 | |
| Fluoroquinolone | 98 (36.4) | 45 (33.3) | 53 (39.6) | 0.35 | |
*ICU, intensive care unit; NICU, neonatal ICU.
†May be multiple.
‡Reference ranges: leukocyte count, 4.0–10.8 × 109 cells/L; hemoglobin concentration, 13.0–17.4 g/dL for adult male and 11.7–16.0 g/dL for adult female; platelet count, 150–400 × 109/L; erythrocyte sedimentation rate, 0–15 mm/h for male and 0–20 mm/h for female; total bilirubin, 0.5–1.8 mg/dL for adult male, 0.4–1.5 mg/dL for adult female; serum creatinine, 0.68–1.19 ng/mL for adult male and 0.49–0.91 ng/mL for adult female; C-reactive protein, 0–8 mg/L.
§Includes aminopenicillin, β-lactam/β-lactamase inhibitor.
1These authors contributed equally to this article.
Page created: December 17, 2018
Page updated: December 17, 2018
Page reviewed: December 17, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.