Descriptive Epidemiology of Acute Pyelonephritis in Korea, 2010–2014: Population-based Study

Abstract

BackgroundAcute pyelonephritis (APN) is one of the most common community-acquired bacterial infections. Recent increases of antimicrobial resistance in urinary pathogens might have changed the other epidemiologic characteristics of APN. The objective of this study was to describe the current epidemiology of APN in Korea, using the entire population.MethodsFrom the claims database of the Health Insurance Review and Assessment Service in Korea, the patients with International Classification of Diseases, 10th Revision codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, neither acute nor chronic) as the primary discharge diagnosis during 2010–2014 were analyzed, with two or more claims during a 14-day period considered as a single episode.ResultsThe annual incidence rate of APN per 10,000 persons was 39.1 and was on the increase year to year (35.6 in 2010; 36.7 in 2011; 38.9 in 2012; 40.1 in 2013; 43.8 in 2014, P = 0.004). The increasing trend was observed in both inpatients (P = 0.014) and outpatients (P = 0.004); in both men (P = 0.042) and women (P = 0.003); and those aged under 55 years (P = 0.014) and 55 years or higher (P = 0.003). Eleven times more women were diagnosed and treated with APN than men (men vs. women, 6.5 vs. 71.3), and one of every 4.1 patients was hospitalized (inpatients vs. outpatients, 9.6 vs. 29.4). The recurrence rate was 15.8%, and the median duration from a sporadic episode (i.e., no episode in the preceding 12 months) to the first recurrence was 44 days. The recurrence probability increased with the number of previous recurrences. The average medical cost per inpatient episode was USD 1,144, which was 12.9 times higher than that per outpatient episode (USD 89).ConclusionThe epidemiology of APN in Korea has been changing with an increasing incidence rate.

Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade

“…As time goes by, the characteristics of disease change. According to recent studies about APN in South Korea using the claim database from 2010 to 2014, the annual incidence rate was on the increase year upon year and prescription of broad-spectrum antibiotics for the treatment of APN had increased [ 10 , 11 ]. In the present study, we identified the change in characteristics of CA-APN in South Korea from the clinical aspect.…”

“…As known, South Korea has been experiencing rapid aging and is expected to become one of the most aged countries in the world [ 9 ]. Furthermore, entry barriers to the hospitals have decreased due to the improvement of the social welfare system and the rapid expansion of private medical insurance in the last decade [ 10 ]. Accordingly, we could find that the epidemiologic characteristics of APN, such as the incidence and medical cost, as well as antibiotic prescription patterns for the treatment of APN, have changed in South Korea [ 10 , 11 ].…”

Differences between Risk Factors for Sepsis and Septic Shock in Obstructive Urolithiasis

“… 2 A Korean study reported that the annual incidence rate of APN per 10,000 individuals has been increasing every year. 3 …”

Trend of antibiotics usage for acute pyelonephritis in Korea based on national health insurance data 2010–2014

“…Acute pyelonephritis (APN) is one of the most common community-acquired bacterial infections, which usually require antibiotic treatment [1]. The annual incidence rate of APN is 39.1 per 10,000 adults in Korea (9.6 per 10,000 adults for inpatients; 29.4 per 10,000 adults for outpatients), and eleven times more women are diagnosed with APN than men [2]. Enterobacteriaceae are common uropathogen, and Escherichia coli is the most common among them.…”