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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 Choi1Comments to Author , In-Yong Lee, Tai-Soon Yong, Dongeun Yong, Seok Hoon Jeong, and Kyungwon Lee1Comments to Author 
Author affiliations: National Health Insurance Service Ilsan Hospital, Goyang, South Korea (M.H. Choi); Yonsei University College of Medicine, Seoul, South Korea (M.H. Choi, M. Kim, S.J. Jeong, J.Y. Choi, I.-Y. Lee, T.-S. Yong, D. Yong, S.H. Jeong, K. Lee)

Main Article

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.

Main Article

1These authors contributed equally to this article.

Page created: December 17, 2018
Page updated: December 17, 2018
Page reviewed: December 17, 2018
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