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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.
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 community-acquired (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).
CONCLUSIONS: 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.
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 community-acquired (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).
CONCLUSIONS: 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.
摘要：
背景：化脓性肌炎（PM）是一种严重的软组织感染，尽管其临床重要性，以前的研究还不能完全确定韩国PM的临床特征和微生物流行病学，因此，我们旨在调查。
方法：我们回顾性地确定了2012年1月至2015年12月期间来自13家综合医院的140名确诊为PM的成年患者。我们分析了社区起病PM的临床和微生物特征，并将其与社区获得性（CA）和医疗保健相关（HCA）PM进行了比较。
结果：从96例（68.6％）PM患者中分离出111种生物。金黄色葡萄球菌（38例）是最常见的病原体，其次是链球菌（24例），和肠道革兰氏阴性菌（27例）。在4例（2.9%）患者中发现耐甲氧西林金黄色葡萄球菌（MRSA），住院死亡率达到8.6%（12/140）。仅在HCAPM亚组中鉴定了肠球菌分离株。MRSA分离株的比例在CA和HCAPM亚组之间没有可比性。在83例感染单一病原菌的PM患者中，革兰氏阴性菌的分离株在HCAPM亚组中比在CAPM亚组中更常见（HCAPM患者的47.6％[10/21]与20.7%[12/58]的CAPM患者；P=0.01)。
结论：革兰氏阳性球菌如金黄色葡萄球菌和链球菌是社区型PM的主要病因，而MRSA在韩国似乎是一种罕见的PM致病生物。肠道革兰氏阴性菌也应被视为主要病因，特别是在韩国的HCAPM患者人群中。
方法：我们回顾性地确定了2012年1月至2015年12月期间来自13家综合医院的140名确诊为PM的成年患者。我们分析了社区起病PM的临床和微生物特征，并将其与社区获得性（CA）和医疗保健相关（HCA）PM进行了比较。
结果：从96例（68.6％）PM患者中分离出111种生物。金黄色葡萄球菌（38例）是最常见的病原体，其次是链球菌（24例），和肠道革兰氏阴性菌（27例）。在4例（2.9%）患者中发现耐甲氧西林金黄色葡萄球菌（MRSA），住院死亡率达到8.6%（12/140）。仅在HCAPM亚组中鉴定了肠球菌分离株。MRSA分离株的比例在CA和HCAPM亚组之间没有可比性。在83例感染单一病原菌的PM患者中，革兰氏阴性菌的分离株在HCAPM亚组中比在CAPM亚组中更常见（HCAPM患者的47.6％[10/21]与20.7%[12/58]的CAPM患者；P=0.01)。
结论：革兰氏阳性球菌如金黄色葡萄球菌和链球菌是社区型PM的主要病因，而MRSA在韩国似乎是一种罕见的PM致病生物。肠道革兰氏阴性菌也应被视为主要病因，特别是在韩国的HCAPM患者人群中。
