Urogenital Tract Infection

Original Articles

Characteristics and Treatment Trends for Emphysematous Pyelonephritis in Korea: A 10-Year Multicenter Retrospective Study: Seung-Kwon Choi, Koo Han Yoo, Jeong Woo Lee, Seung Il Jung, Eu Chang Hwang, Joongwon Choi, Woong Bin Kim, Jung Sik Huh, Jin Bong Choi, Yeonjoo Kim, Jae Min Chung, Ju-Hyun Shin, Jae Hung Jung, Hong Chung, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2021;16(2):49-54. Published online August 31, 2021; DOI: https://doi.org/10.14777/uti.2021.16.2.49

Abstract PDF PubReader ePub: Purpose: This study examined the characteristics, current treatment trends, and outcomes of patients with emphysematous pyelonephritis (EPN) in Korea.
Materials andMethods: Two hundred and seventeen patients diagnosed with EPN were evaluated using abdominal computed tomography in 2011-2021 at 15 institutes in Korea. The patients’ demographic and clinical characteristics, treatment modalities, and treatment outcomes were analyzed. The total study period was divided arbitrarily into groups A (2011-2014), B (2015-2017), and C (2018-2021) to analyze the trends in the EPN treatment.
Results: The mean age of the patients was 65.1 years; there were more female patients (74.2%) than male patients. The overall mortality rate was 10.6%. Ninety-five (43.8%), 98 (45.2%), and 24 (11.0%) patients were treated with medical, minimally invasive, and surgical management, respectively; the corresponding mortality rates were 13.7%, 6.1%, and 16.7%. There was no significant change in the proportion of patients treated with medical management over time (group A=46.5%, group B=47.0%, and group C=38.8%). The proportion of patients treated with minimally invasive management gradually increased over time (group A=35.2%; group B=43.9%; group C=55.0%), while those who underwent surgical management decreased gradually over time (group A=18.3%, group B=9.1%, and group C=6.3%). No differences in mortality rates were observed between the groups.
Conclusions: EPN with medical and minimally invasive management had a relatively high treatment success rate, which increased gradually, while surgical management decreased gradually over time in Korea. The mortality rate was relatively lower than that reported in studies published before the 2010s.

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Clinical Characteristics and Antimicrobial Susceptibility of Elderly Women with Acute Pyelonephritis: Ji Kang Yun, Woong Bin Kim, Sang Wook Lee, Kwang Woo Lee, Jun Mo Kim, Young Ho Kim; Urogenit Tract Infect 2020;15(3):71-78. Published online December 31, 2020; DOI: https://doi.org/10.14777/uti.2020.15.3.71

Abstract PDF PubReader ePub: Purpose: Acute pyelonephritis in older patients can lead to a poorer treatment response and prognosis. The objective of this study was to classify older female patients with acute pyelonephritis according to age and compare their clinical characteristics and antibiotic susceptibility.
Materials and Methods: In this retrospective study, 360 patients aged 65 years or older and hospitalized for acute pyelonephritis in a single tertiary medical facility from 2012 to 2016 were selected as research subjects. The patients were divided into three groups according to their age. Their clinical symptoms, blood tests and urinalysis, underlying diseases, causative organisms for urinary tract infections (UTIs), and antibiotic susceptibility were compared.
Results: One hundred and seventy-six patients aged 69.9±2.7 years, 142 patients aged 79.4±3.1 years, and 42 patients aged 87.3±3.1 years were assigned into the young-old, old-old, and oldest-old groups, respectively. The duration of hospitalization and fever due to acute pyelonephritis increased with age. On the other hand, the maximum body temperature was similar among the three groups. In blood tests, erythrocyte sedimentation rate and C-reactive protein increased with age. Among the underlying diseases, the incidence of diabetes and chronic renal disease was similar among the three groups, while cerebrovascular diseases, heart failure, and urinary stones were associated with aging. Older patients were more likely to have UTIs over the past year. Older groups showed a more significant decrease in sensitivity to carbapenems, amikacin, and ciprofloxacin.
Conclusions: Choosing appropriate antibiotics, considering the patientʼs age, is important when treating acute pyelonephritis.

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Risk Factors of Febrile Urinary Tract Infection after Ureteral Reimplantation in Infant: Seungsoo Lee, Jae Min Chung, Sang Don Lee; Urogenit Tract Infect 2020;15(2):33-37. Published online August 31, 2020; DOI: https://doi.org/10.14777/uti.2020.15.2.33

Abstract PDF PubReader ePub

Purpose: Children with febrile urinary tract infection (fUTI) and vesicoureteral reflux (VUR) show significant morbidity. Few studies have examined the incidence of fUTI after ureteral reimplantation for congenital urinary tract anomalies, particularly in infants. Therefore, this study examined the incidence and risk factors of fUTI after ureteral reimplantation in infants.
Materials and Methods: Children under one year of age, who underwent ureteral reimplantation from July 2017 to December 2018, were reviewed retrospectively. The patients’ data were analyzed to evaluate the predictors of fUTI after ureteral reimplantation.
Results: Ureteral reimplantation was performed in 16 patients (25 ureters) at a mean of 8.9±2.8 months. The preoperative diagnosis was VUR 14 (87.5%), obstructive megaureter 1 (6.3%), duplicated ureter 1 (6.3%). Postoperative fUTI occurred in five patients (31.3%) during the follow-up period (average 9.6±5.9 months, range 3-18 months). UTI occurred at 40.8±16.6 (17-61) days after surgery. Fourteen ureters were implanted with a ureteral catheter for three days, and 11 ureters were implanted with a double J ureteral stent for six weeks. The children’s age, sex, surgical method, renal scar, reflux grade, laterality, persisting VUR, and presence of double J ureteral stent were not predictive factors for postoperative fUTI.
Conclusions: The incidence of fUTI after ureteral reimplantation in infants was 31.3%, and all fUTI occurred within two months after surgery. The risk factors associated with fUTI after ureteral reimplantation could not be predicted.

Citations

Citations to this article as recorded by

Etiological Agents of Urinary Tract Infection (UTI)
Rana Thamer Hadi Alkhafaji, M. Jayashankar
International Journal of Scientific Research in Science and Technology.2022; : 381. CrossRef

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