Ann Clin Microbiol 2025;28(4):20. Factors influencing microbial diagnostic testing for infectious diseases in Korea: a nationwide retrospective cohort study
| Characteristics | Variates | Pneumonia | Bloodstream infection | Urinary tract infection | Soft tissue infection | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total (n) | Incidence rate (%) | OR | 95% CI | P-value | Total (n) | Incidence rate (%) | OR | 95% CI | P-value | Total (n) | Incidence rate (%) | OR | 95% CI | P-value | Total (n) | Incidence rate (%) | OR | 95% CI | P-value | ||
| Sex | Male | 1,158,288 | 4.50 | 1 | – | – | 787,410 | 3.06 | 1 | – | – | 1,181,580 | 4.59 | 1 | – | – | 2,965,689 | 11.52 | 1 | – | – |
| Female | 1,331,530 | 5.19 | 0.789 | 0.782 – 0.796 | <0.0001 | 1,177,562 | 4.59 | 0.856 | 0.840 – 0.872 | <0.0001 | 2,827,982 | 11.02 | 1.440 | 1.426 – 1.455 | <0.0001 | 4,439,665 | 17.29 | 0.781 | 0.773-0.789 | <.0001 | |
Age (yr) | ≤ 19 | 878,496 | 10.77 | 1 | – | – | 369,517 | 4.53 | 1 | – | – | 363,021 | 4.45 | 1 | – | – | 1,034,285 | 12.68 | 1 | – | – |
| 20-29 | 154,422 | 2.33 | 0.245 | 0.237 – 0.254 | <0.0001 | 218,816 | 3.30 | 0.148 | 0.139 – 0.158 | <0.0001 | 345,349 | 5.21 | 0.269 | 0.263 – 0.276 | <0.0001 | 813,367 | 12.28 | 0.775 | 0.747-0.804 | <0.0001 | |
| 30-39 | 196,214 | 2.83 | 0.275 | 0.267 – 0.283 | <0.0001 | 225,691 | 3.26 | 0.154 | 0.146 – 0.163 | <0.0001 | 433,155 | 6.26 | 0.218 | 0.213 – 0.224 | <0.0001 | 885,662 | 12.79 | 0.729 | 0.705-0.754 | <0.0001 | |
| 40-49 | 216,575 | 2.65 | 0.306 | 0.299 – 0.314 | <0.0001 | 233,956 | 2.86 | 0.193 | 0.184 – 0.203 | <0.0001 | 522,278 | 6.39 | 0.237 | 0.232 – 0.242 | <0.0001 | 972,174 | 11.89 | 0.732 | 0.71-0.755 | <0.0001 | |
| 50-59 | 232,689 | 2.70 | 0.351 | 0.344 – 0.358 | <0.0001 | 279,990 | 3.25 | 0.220 | 0.211 – 0.229 | <0.0001 | 698,113 | 8.10 | 0.265 | 0.260 – 0.270 | <0.0001 | 1,175,666 | 13.64 | 0.785 | 0.762-0.807 | <0.0001 | |
| 60-69 | 307,508 | 4.24 | 0.415 | 0.407 – 0.422 | <0.0001 | 298,548 | 4.12 | 0.283 | 0.273 – 0.294 | <0.0001 | 762,451 | 10.52 | 0.296 | 0.291 – 0.302 | <0.0001 | 1,219,787 | 16.83 | 0.949 | 0.923-0.976 | 0.6523 | |
| 70-79 | 256,790 | 7.11 | 0.615 | 0.604 – 0.626 | <0.0001 | 202,898 | 5.62 | 0.408 | 0.393 – 0.424 | <0.0001 | 529,278 | 14.66 | 0.410 | 0.402 – 0.418 | <0.0001 | 808,478 | 22.40 | 1.310 | 1.273-1.347 | <0.0001 | |
| ≥ 80 | 247,124 | 12.03 | 1.218 | 1.197 – 1.239 | <0.0001 | 135,556 | 6.60 | 0.586 | 0.565 – 0.609 | <0.0001 | 355,917 | 17.33 | 0.821 | 0.806 – 0.836 | <0.0001 | 495,935 | 24.15 | 1.672 | 1.625-1.721 | <0.0001 | |
Insurance quintile | Medical benefits | 117,885 | 7.74 | 1 | – | – | 95,896 | 6.30 | 1 | – | – | 189,335 | 12.44 | 1 | – | – | 317,294 | 20.84 | 1 | – | – |
| 1st | 500,468 | 4.95 | 0.824 | 0.808 – 0.839 | 0.0011 | 407,336 | 4.03 | 0.924 | 0.892 – 0.958 | 0.4517 | 874,066 | 8.65 | 0.769 | 0.754 – 0.784 | <0.0001 | 1,566,003 | 15.50 | 0.765 | 0.750-0.780 | <0.0001 | |
| 2nd | 404,582 | 3.87 | 0.845 | 0.829 – 0.861 | 0.0337 | 362,397 | 3.47 | 0.937 | 0.903 – 0.973 | 0.0406 | 742,253 | 7.11 | 0.782 | 0.767 – 0.798 | 0.4451 | 1,398,004 | 13.38 | 0.800 | 0.784-0.816 | 0.6651 | |
| 3rd | 624,273 | 4.94 | 0.826 | 0.811 – 0.841 | 0.0039 | 460,570 | 3.65 | 0.923 | 0.890 – 0.956 | 0.5587 | 915,774 | 7.25 | 0.760 | 0.745 – 0.775 | <0.0001 | 1,737,600 | 13.76 | 0.765 | 0.750-0.780 | <0.0001 | |
| 4th | 842,610 | 5.01 | 0.71 | 0.698 – 0.723 | <0.0001 | 638,773 | 3.80 | 0.814 | 0.787 – 0.842 | <0.0001 | 1,288,134 | 7.66 | 0.653 | 0.641 – 0.665 | <0.0001 | 2,386,453 | 14.20 | 0.692 | 0.679-0.704 | <0.0001 | |
Residential area | Region 3 | 880,301 | 5.44 | 1 | – | – | 621,568 | 3.84 | 1 | – | – | 1,300,319 | 8.04 | 1 | – | – | 2,367,804 | 14.64 | 1 | – | – |
| Region 2 | 606,751 | 4.71 | 0.958 | 0.947 – 0.968 | <0.0001 | 469,702 | 3.64 | 0.885 | 0.863 – 0.906 | <0.0001 | 993,619 | 7.71 | 0.925 | 0.914 – 0.936 | 0.0485 | 1,770,905 | 13.73 | 0.989 | 0.976-1.003 | <0.0001 | |
| Region 1 | 1,002,766 | 4.20 | 1.020 | 1.010 – 1.030 | <0.0001 | 873,702 | 3.66 | 0.963 | 0.943 – 0.983 | 0.0166 | 1,715,624 | 7.19 | 0.837 | 0.828 – 0.846 | <0.0001 | 3,266,645 | 13.69 | 0.909 | 0.898-0.919 | <0.0001 | |
| Disability | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 1.509 | 1.490 – 1.528 | <0.0001 | 1.387 | 1.354 – 1.421 | <0.0001 | 1.470 | 1.450 – 1.490 | <0.0001 | 1.685 | 1.663-1.706 | <0.0001 | |||||||||
Disease severity (CCI) | 0 | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| 1 | 1.461 | 1.442 – 1.48 | <0.0001 | 0.992 | 0.963 – 1.023 | <0.0001 | 1.036 | 1.022 – 1.050 | <0.0001 | 1.402 | 1.372-1.433 | <0.0001 | |||||||||
| 2 | 1.546 | 1.519 – 1.574 | <0.0001 | 1.320 | 1.272 – 1.371 | <0.0001 | 1.154 | 1.135 – 1.174 | <0.0001 | 1.759 | 1.718-1.801 | <0.0001 | |||||||||
| ≥ 3 | 1.855 | 1.823 – 1.887 | <0.0001 | 1.772 | 1.712 – 1.834 | <0.0001 | 1.340 | 1.319 – 1.362 | <0.0001 | 3.340 | 3.267-3.415 | <0.0001 | |||||||||
Type of medical institutions | Senior general hospitals | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| General hospitals | 0.835 | 0.824 – 0.846 | <0.0001 | 0.377 | 0.368 – 0.386 | <0.0001 | 0.912 | 0.900 – 0.924 | <0.0001 | 0.628 | 0.618-0.638 | <0.0001 | |||||||||
| Hospitals | 0.462 | 0.455 – 0.469 | <0.0001 | 0.077 | 0.074 – 0.080 | <0.0001 | 0.481 | 0.473 – 0.489 | <0.0001 | 0.513 | 0.502-0.523 | <0.0001 | |||||||||
| Clinics | 0.065 | 0.064 – 0.066 | <0.0001 | 0.010 | 0.010 – 0.011 | <0.0001 | 0.080 | 0.079 – 0.082 | <0.0001 | 0.197 | 0.195-0.200 | <0.0001 | |||||||||
| Nursing hospital | 0.700 | 0.685 – 0.715 | <0.0001 | 0.784 | 0.761 – 0.808 | <0.0001 | 0.727 | 0.704 – 0.751 | <0.0001 | 1.243 | 1.210-1.277 | <0.0001 | |||||||||
| Othersa) | 0.137 | 0.117 – 0.161 | <0.0001 | 0.023 | 0.017 – 0.031 | <0.0001 | 0.136 | 0.122 – 0.152 | <0.0001 | 0.351 | 0.324-0.380 | <0.0001 | |||||||||
Chemotherapy in solid cancer | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 1.358 | 1.328 – 1.389 | <0.0001 | 1.751 | 1.686 – 1.819 | <0.0001 | 0.955 | 0.931 – 0.979 | 0.0003 | 1.898 | 1.858-1.940 | <0.0001 | |||||||||
Hematologic malignancy | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 1.782 | 1.711 – 1.856 | <0.0001 | 1.839 | 1.730 – 1.954 | <0.0001 | 1.182 | 1.118 – 1.250 | <0.0001 | 1.887 | 1.809-1.968 | <0.0001 | |||||||||
Organ transplantation | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 1.585 | 1.504 – 1.67 | <0.0001 | 1.396 | 1.283 – 1.518 | <0.0001 | 1.664 | 1.575 – 1.758 | <0.0001 | 2.029 | 1.940-2.122 | <0.0001 | |||||||||
| HIV infection | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 0.855 | 0.747 – 0.980 | 0.0243 | 0.536 | 0.418 – 0.688 | <0.0001 | 0.515 | 0.432 – 0.615 | <0.0001 | 0.833 | 0.723-0.960 | 0.0117 | |||||||||
| Diabetes | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 0.899 | 0.889 – 0.909 | <0.0001 | 0.909 | 0.889 – 0.930 | <0.0001 | 0.942 | 0.932 – 0.953 | <0.0001 | 2.613 | 2.573-2.654 | <0.0001 | |||||||||
Alcoholic dependence | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 2.088 | 2.001 – 2.179 | <0.0001 | 1.692 | 1.562 – 1.832 | <0.0001 | 1.845 | 1.759 – 1.935 | <0.0001 | 1.712 | 1.642-1.785 | <0.0001 | |||||||||
| Malnutrition | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 1.927 | 1.883 – 1.971 | <0.0001 | 1.828 | 1.754 – 1.906 | <0.0001 | 1.698 | 1.651 – 1.746 | <0.0001 | 1.765 | 1.717-1.815 | <0.0001 | |||||||||
Steroid treatment | No | 1 | – | – | 1 | – | – | 1 | – | – | 1 | – | – | ||||||||
| Yes | 1.227 | 1.216 – 1.237 | <0.0001 | 0.911 | 0.894 – 0.928 | <0.0001 | 1.093 | 1.083 – 1.104 | <0.0001 | 1.141 | 1.130-1.153 | <0.0001 | |||||||||
| Pregnancy | No | 1 | – | – | |||||||||||||||||
| Yes | 0.712 | 0.685 – 0.740 | <0.0001 | ||||||||||||||||||
| Necrotizing fasciitis | No | 1 | – | – | |||||||||||||||||
| Yes | 13.21 | 11.912-14.649 | <0.0001 | ||||||||||||||||||
| Pyogenic arthritis | No | 1 | – | – | |||||||||||||||||
| Yes | 3.21 | 3.097-3.328 | <0.0001 | ||||||||||||||||||
| Clostridium muscle necrosis | No | 1 | – | – | |||||||||||||||||
| Yes | 9.751 | 6.077-15.647 | <0.0001 | ||||||||||||||||||
| Open wounds by bites | No | 1 | – | – | |||||||||||||||||
| Yes | 1.199 | 1.182-1.216 | <0.0001 | ||||||||||||||||||
Bold form: statistically significant.
a)Others included dental hospitals, healthcare centers, child health centers, and oriental medicine clinics.
Abbreviations: OR, odds ratio; CI, confidence interval; CCI, Charlson comorbidity index; HIV, human immunodeficiency virus.