Effect of Preoperative Bacteriuria and Pyuria on Intravesical Recurrence in Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy

Fukushima, Hiroshi; Kobayashi, Masaki; Kawano, Keizo; Morimoto, Shinji

doi:10.21873/invivo.11193

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…Many demographic factors and clinical features were analyzed as risk factors for bacteriuria in cancer patients in this study, however, no evidence was found to support the association between bacteriuria and demographic and clinical features of the cancer patients (P > 0.05). Correspondingly, in other studies [ 24 – 26 ] reported that neither of the factors and clinical features mentioned in our study had no effect on the occurrence of bacteriuria.…”

Section: Discussionsupporting

confidence: 74%

Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

et al. 2020

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Background Urinary tract infections are the most common causes of morbidity and mortality in patients with cancer. The emergence of multiple-drug-resistant (MDR) strains of gram-negative bacteria causing urinary tract infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of bacterial isolates related to urinary tract infections among cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods and materials Hospital based prospective cross-sectional study was conducted for three months from January to March 2018 in tertiary care hospital located in the capital city of the country. Gram-negative bacteria isolated from urine specimens from hospitalized patients with cancer were characterized using standard microbiological methods. Modified Kirby–Bauer disk diffusion technique was applied for antimicrobial susceptibility testing in accordance with CLSI 2019 criteria. Results Of totally 292 urine samples tested, eighteen (6.3%) were culture positive cases, Escherichia coli (44.4%) was the highest proportion isolated uropathogen followed by Klebsiella pneumoniae (22.2%) and Citrobacter diversus (16.7%). The antibiotic susceptibility results showed meropenem and nitrofurantoin as the most effective antibiotics for E. coli, K. pneumoniae, and Citrobacter diversus isolates. The rate of multidrug resistant (MDR) isolates were 33.3% (6/18), and meropenem and nitrofurantoin were the most effective antibiotic against MDR isolates. Conclusion The study findings showed a significant distribution of MDR gram-negative bacteria which may increase the burden of urinary tract associated infections in cancer patients. Carbapenem (meropenem) can be considered as effective agents to treat MDR cases in our region.

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Section: Discussionsupporting

confidence: 74%

Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

et al. 2020

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“…Jeon et al [ 12 ] assessed 176 patients with UTUC and found that preoperative pyuria was associated with a higher risk for IVR. By contrast, Fukushima et al [ 13 ] analyzed 97 patients and asserted that pyuria could lower the risk for IVR after RNUx. Moreover, Milojevic et al [ 14 ] assessed 319 patients and suggested that preoperative pyuria was not correlated with IVR in patients with UTUC.…”

Section: Discussionmentioning

confidence: 99%

“…First, this was a retrospective study with possible selection bias, and further well-designed studies are required to confirm these results. Second, the definition of pyuria varies among studies, and even if we exclude bacteriuria, there are conditions other than tumors, such as inflammation or autoimmune diseases, that can cause pyuria [ 6 7 9 10 11 12 13 14 ]. Third, the reason neoadjuvant chemotherapy increased the risk for tumor recurrence is most likely because the patients with a history of neoadjuvant chemotherapy had a biased advanced cancer profile ( Supplementary Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pathologic information included pathologic tumor, necrosis, and metastases stages; World Health Organization histologic grade; histologic variant; concomitant carcinoma in situ ; lymphovascular invasion; and condition of the surgical margin [ 15 16 ]. Pyuria was defined as five or more white blood cells per high-power field in centrifuged urine, in accordance with previous studies, and the urinalysis was done before the surgery [ 6 7 12 13 ]. Hydronephrosis was assessed with an abdomen-pelvis CT image.…”

Section: Methodsmentioning

confidence: 99%

“…Some studies assert that preoperative pyuria can predict worse IVR-free survival (IVRFS) after RNUx [ 11 12 ]. Other studies claim that pyuria is related to better IVRFS, while other studies contend that it cannot predict IVR [ 13 14 ]. This study aimed to research the value of preoperative pyuria in predicting IVR in patients with UTUC after RNUx.…”

Section: Introductionmentioning

confidence: 99%

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Pyuria as an independent predictor of intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial carcinoma

et al. 2023

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Purpose About one-third of patients who undergo radical nephroureterectomy (RNUx) for upper tract urothelial carcinoma (UTUC) experience intravesical recurrence (IVR). This study investigated whether pyuria is a feasible predictor of IVR after RNUx in patients with UTUC. Materials and Methods Seven hundred forty-three patients with UTUC who underwent RNUx at a single institute were analyzed in this study. The participants were divided into two groups: those without pyuria (non-pyuria) and those with pyuria. Kaplan–Meier survival analysis was performed, and p-values were assessed using the log-rank test. Cox regression analyses were performed to identify the independent predictors of survival. Results The pyuria group had a shorter IVR-free survival period (p=0.009). The five-year IVR-free survival rate was 60.0% in the non-pyuria group vs. 49.7% in the pyuria group according to the Kaplan-Meier survival analysis. After the multivariate Cox regression analysis, pyuria (hazard ratio [HR]=1.368; p=0.041), a concurrent bladder tumor (HR=1.757; p=0.005), preoperative ureteroscopy (HR=1.476; p=0.013), laparoscopic surgery (HR=0.682; p=0.048), tumor multiplicity (HR=1.855; p=0.007), and a larger tumor (HR=1.041; p=0.050) were predictors of risk for IVR. There was no association between pyuria and recurrence-free survival (p=0.057) or cancer-specific survival (p=0.519) in the Kaplan–Meier survival analysis. Conclusions This study concluded that pyuria was an independent predictor of IVR in patients with UTUC after RNUx.

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Impact of urinary tract infection on nursing and healthcare-associated pneumonia

Yamazoe

Tomioka

Wada

2019

Journal of Infection and Chemotherapy

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Effect of Preoperative Bacteriuria and Pyuria on Intravesical Recurrence in Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy

Abstract: Abstract. Background

Cited by 5 publications

References 21 publications

Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Pyuria as an independent predictor of intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial carcinoma

Impact of urinary tract infection on nursing and healthcare-associated pneumonia

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