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Risk Factors of Sepsis in Obstructive Acute Pyelonephritis Associated with Urinary Tract Calculi
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Chae Hong Lim, Jae Seung Hwang, Dae Ji Kim, Seok Heun Jang, Jeong Hwan Son, Dae Sung Cho, Jae Won Lee
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Urogenit Tract Infect 2015;10(2):108-111. Published online October 31, 2015
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 Abstract
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- Purpose: The aim of this study is to identify the risk factors for development of sepsis in patients with obstructive acute pyelonephritis (APN) associated with urinary tract calculi.
Materials and Methods: Between January 2004 and December 2013, 73 patients with obstructive APN associated with upper urinary tract calculi were admitted to our institution. Medical records of 73 patients (14 men and 59 women, mean age of 57 years) were reviewed retrospectively. The risk factors for sepsis were analyzed using multivariate logistic regression analysis.
Results: Of 73 patients, 37 (50.7%) developed sepsis. Old age and history of hypertension were more common in the sepsis group than in the non-sepsis group (p＜0.001 and p=0.018). The white blood cell count, neutrophil count, plateletto- lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein level were significantly higher in the sepsis group (p=0.011, p=0.001, p=0.042, p＜0.001 and p=0.006, respectively). Lymphocyte count, platelet count, and albumin level were significantly lower in the sepsis group (p＜0.001, p=0.008 and p＜0.001, respectively). Multivariate logistic regression analysis indicated that old age (odds ratio [OR], 2.13; p=0.023), decrease in serum albumin level (OR, 4.27; p=0.041), and high NLR (OR, 3.83; p=0.037) were independent risk factors for development of sepsis.
Conclusions: Elderly patients with obstructive APN associated with urinary tract calculi who have low serum albumin levels and high NLR should be treated carefully against development of sepsis.
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Septic Pulmonary Embolism Secondary to Prostate Abscess
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Keun Bai Moon, Go San Lim, Jae Seung Hwang, Chae Hong Lim, Dae Ji Kim, Jeong Hwan Son
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Korean J Urogenit Tract Infect Inflamm 2013;8(2):129-132. Published online October 31, 2013
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- A 30-year-old male admitted to our hospital with sudden onset shortness of breath, general weakness, dysuria, frequency, oligouria and fever. Abdominal and chest computed tomography revealed septic pulmonary embolism, multiple thrombi along right common iliac, internal iliac and femoral vein and large size prostatic abscess (right lobe＞5 cm, left lobe＞3.5 cm). We, therefore, diagnosed septic
pulmonary embolism secondary to prostate abscess. Abscess was drained by transurethral resection of prostate with appropriate antibiotics therapy. There were no postoperative complications with complete abscess resolution. Septic pulmonary embolism originated from urinary tract infection is rare. So we present a case report and the review of relevant literatures.
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Changes of Causative Organisms and Antibiotic Sensitivity of Urinary Tract Infection in the Southern Area of Kyoung-gi Do for Recent 4 Years
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Jae Young Jeong, Jeong Hwan Son, Jae Il Kim, Seok Heun Jang
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Korean J Urogenit Tract Infect Inflamm 2010;5(2):167-175. Published online October 31, 2010
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- "Purpose: We studied the changes in antibiotic sensitivity to causative organisms of urinary tract infection for the past 4 years, in order to provide useful information on the choice of adequate drugs for the treatment of urinary tract infection (UTI). Materials and Methods: We analyzed 7,938 uropathogens and their antibiotic sensitivities in 5,609 patients admitted or visited our hospital (located in the southern area of Kyoung-Gi Do) with more than 105cfu/ml of urine culture from January 2006 to December 2009 retrospectively. Results: The incidence of UTI increased with age and was highest in the first decade (33.0%), followed by seventh decade (11.9%). The most common pathogenic organism was E. coli (43.4%), followed by Klebsiella (13.6%), Enterococcus (7.9%), Staphylococcus (4.8%) and Serratia (4.6%). The incidence of E. coli and Klebsiella increased from respectively 39.3% and 10.1% in 2006, to 46.7% and 14.3% in 2009, while the incidence of Enterococcus and Staphylococcus decreased. In E. coli, resistance to antimicrobial agents was increased in ampicillin (69.6 to 72.0%), ciprofloxacin (38.4 to 47.0%), ceftazidime (12.3 to 19.0%), but decreased in trimethoprim/sulfamethoxazole (42.1 to 37%) and sensitivity to amikacine was above 90%. For the Gram-positive organisms, vancomycin and teicoplanin showed higher sensitivities. Conclusions: E. coli is the most common causative organism of UTI and its resistance to antimicrobial agents is increasing. Fluoroquinolone use should be restricted due to high resistance and economic. The use of amikacin or trimethoprim/sulfamethoxazole as empirical treatment for UTI should be considered. "
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