Infect Chemother.  2021 Mar;53(1):46-52. 10.3947/ic.2020.0102.

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

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
  • 2Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
  • 3Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 4Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
  • 5Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 6Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
  • 7Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
  • 8Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
  • 9Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
  • 10Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
  • 11Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
  • 12Department of Internal Medicine, GangNeung Asan Hospital, Gangneung, Korea
  • 13Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
  • 14Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
  • 15The Korean Skin and Soft Tissue Study Group, Korea

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 communityacquired (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.

Keyword

Pyomyositis; Community; Etiology
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