The Clinical Impact of Bacteremia in Complicated Acute Pyelonephritis

Hsu, Chih Yang; Fang, Hua; Chou, Kang Ju; Chen, Chien Liang; Lee, Po‐Tsang; Chung, Hsiao Min

doi:10.1097/00000441-200610000-00004

Cited by 84 publications

(74 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among our geriatric subjects, we found that long hospital stay was a signifi cant predictive factor for anemia instead of renal insuffi ciency, which a local metropolitan study viewed as a risk factor for bacteremia or poor prognosis in patients with acute pyelonephritis (Hsu et al 2006). We found that subjects with serum creatinine > 2.0 mg/dl had longer hospital stays than those with serum creatinine 2.0 mg/dl.…”

Section: Discussionmentioning

confidence: 63%

The Characteristics of Acute Pyelonephritis in Geriatric Patients: Experiences in Rural Northeastern Taiwan

Kang¹,

Tsao²,

Liu³

et al. 2008

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Acute pyelonephritis causes hospitalization and is a commonly-ignored cause of death in geriatric patients. It has been well studied in young-adult populations but rarely in geriatric populations. The aim of our study was to analyze the characteristics of acute pyelonephritis in geriatric patients. The electronic admission records of a community hospital in northeastern Taiwan were retrospectively screened from July 1, 2003 to June 30, 2006. The basic characteristics, laboratory fi ndings and infectious microorganisms of all subjects were evaluated. Sixty-fi ve subjects (mean age 71.6 ± 4.9 years; range 65-84 years) and 73 admission records contributed by them were enrolled. These 65 subjects, including one who died in hospital, were predominantly female (52 subjects; 80%). Twenty-two subjects (33.8%) had co-existing diabetes mellitus, 9 subjects (13.8%) had co-existing tumors, and 19 subjects (29.2%) had a history of intra-abdominal surgery. The admission records revealed right kidney involvement (52.1%), co-existing urolithiasis (50.7%) and admission to wards of internal medicine (57.5%). Urological procedures were performed on 20 (27.4%) of all 73 admission records. Escherichia coli was the most common infecting microorganism (19.2% of all records; 42.4% of records with positive microorganism culture). Hemoglobin < 10 g/dl was a signifi cant predictive factor for both hospital stay > 7 days and serum creatinine > 2.0 mg/dl ( p = 0.003 and 0.002, respectively). Positive microorganism culture was also a signifi cant predictive factor for hospital stays > 7 days ( p < 0.001). In our geriatric patients with acute pyelonephritis, low hemoglobin levels implied co-existing renal insuffi ciency and prolonged hospitalization. Positive microorganism culture also implied prolonged hospitalization.

show abstract

Section: Discussionmentioning

confidence: 63%

The Characteristics of Acute Pyelonephritis in Geriatric Patients: Experiences in Rural Northeastern Taiwan

Kang¹,

Tsao²,

Liu³

et al. 2008

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…In cases with complicated acute pyelonephritis, advanced age has been detected as a risk factor for bacteremia. [2] On the other hand, malignancy, and indwelling urinary catheter have been demonstrated as independent risk factors for bacteremia. [15] These risk factors for bacteremia were also observed in our cases.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Bacterial agent is most often Escherichia coli, while Gram-negative cocci, enterococci, and Staphylococcus saprophyticus may also cause this infection. [4] In recent studies, extended-spectrum beta-lactamase (ESBL) producing strains have been detected in E.coli isolates at a higher frequency, both in the world, and in our country.…”

Section: Introductionmentioning

confidence: 99%

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

Dökmetaş¹,

Hamidi²,

Bulut³

et al. 2017

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. Material and methods:We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015. Cases in which the same causative microorganism grew in both blood and urine cultures were included in the study. Patients using ceftriaxone and carbapenem as empirical antibiotic therapy (EAT) were compared as two different groups. In cases that the ethiologic agents were extended-spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli isolates, if the microorganism was resistant to initial antibiotic treatment the situation was defined as EAT discordance, and if it was sensitive it was defined as EAT concordance. Results:After the exclusion criteria were applied, 65 of the 266 cases examined were taken into the study. Clinical and laboratory features of cases of ceftriaxone and carbapenem groups were similar. There was no statistically significant difference between the two groups in terms of hospital stay and survival (p>0.05). Of 28 cases of ESBL-producing E. coli and K. pneumoniae, 18 were EAT discordant and 10 were EAT concordant. Clinical and laboratory features of EAT concordant and EAT discordant groups were similar. No statistically significant difference was found between the two groups in terms of hospital stay and survival (p>0.05). Conclusion:It was considered that ceftriaxone can still be a viable option in the EAT of UTI, which is accompanied by bacteremia without severe sepsis and septic shock findings. It was concluded that EAT discordance may not have a negative effect on the duration of hospital stay and survival rates in neither total cases nor ESBL positive ones.Keywords: Bacteremia; empirical antibiotic therapy; urinary tract infection.Cite this article as: Dökmetaş İ, Hamidi AA, Bulut ME, Çetin S, Öncül A, Uzun N. Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia. Turk J Urol 2017; 43(4): 543-8.

show abstract

“…Kamei et al [11] reported that a positive blood culture is a risk factor for septic shock in patients with obstructive pyelonephritis (OR, 9.11), and bacteremia in severe acute pyelonephritis showed significant association with a hospital stay longer than 14 days (OR, 3.71) [12]. Hsu et al [1] reported that patients with a positive blood culture in complicated acute pyelonephritis were likely to present with severe sepsis (OR, 4.76). However the results of a blood culture take at least 8-12 hours, therefore its use as a predictive factor may be difficult in routine clinical practice [22,23].…”

Section: ) Bacteremiamentioning

confidence: 99%

“…Severe conditions sometimes occur in patients with acute complicated pyelonephritis, and bacteremia has been reported in 20-41% [1,2].…”

Section: Introductionmentioning

confidence: 99%

What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

Kamei

Homma

2016

Urogenit Tract Infect

View full text Add to dashboard Cite

Acute obstructive pyelonephritis is a common urological infection, often requiring emergency drainage, which shows rapid progression to serious conditions, including severe sepsis or septic shock. Therefore, during an initial evaluation, knowledge of factors for prediction of severe conditions or mortality is important for immediate identification of patients requiring intensive care. Previous studies examining the characteristics of patients with acute obstructive or calculous pyelonephritis reported rates of septic shock and mortality of 20.8-33.3% and 0-7.4%, respectively. Thrombocytopenia, older age, low serum albumin, and bacteremia were relatively common predictors for septic shock. In contrast, age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness, male gender, and having only one kidney were predictive factors for mortality.

show abstract

The Clinical Impact of Bacteremia in Complicated Acute Pyelonephritis

Cited by 84 publications

References 30 publications

The Characteristics of Acute Pyelonephritis in Geriatric Patients: Experiences in Rural Northeastern Taiwan

The Characteristics of Acute Pyelonephritis in Geriatric Patients: Experiences in Rural Northeastern Taiwan

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

What Are the Predictive Factors of Severe Conditions in Acute Obstructive Pyelonephritis?

Contact Info

Product

Resources

About