A Study on the Clinical and Microbiologic Features of Community-acquired Acute Pyelonephritis for the Recent 5 Years in a University Hospital.
- Author:
Jin Seo LEE
1
;
Seung Hyuk RHO
;
Seong Eun KIM
;
Taek Man NAM
;
Jae Seok KIM
;
Seong Gyun KIM
;
Young Ki LEE
;
Jung Woo NOH
;
Dong Wan CHAE
;
Kook Hwan OH
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea. ohchris@hanmail.net
- Publication Type:Original Article
- Keywords:
Acute pyelonephritis;
E. coli;
ciprofloxacin;
antibiotic sensitivity
- MeSH:
Abscess;
Amikacin;
Aminoglycosides;
Ampicillin;
Anti-Bacterial Agents;
Cefazolin;
Cephalosporins;
Cephalothin;
Chronic Disease;
Ciprofloxacin;
Female;
Heart;
Humans;
Male;
Medical Records;
Prevalence;
Pyelonephritis*;
Shock, Septic
- From:Korean Journal of Nephrology
2002;21(6):905-913
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose : The clinical features and microbiologic characteristics of acute pyelonephritis (APN) have been changing due to an increased prevalence of chronic disease, overuse and/or misuse of antibiotics and so on. We investigated the causative organisms and their antibiotic sensitivity profile and clinical manifestation with the purpose to suggest a proper empirical therapy of the disease. METHODS: We analysed the medical records of 246 APN patients older than 15 years who were admitted at Hallym University, Kandong Sacred Heart Hospital from January 1997 to December 2001, excluding hospital-acquired infections. RESULTS: Patients were 46.2+/-19.0 years old with male : female ratio of 1 : 10.2. The severity score was 4.43+/-1.63 out of 8. The average duration of hospital admission was 6.1+/-2.8 days and all of the cases were cured without a complication such as septic shock or renal abscess. In 133 cases, their etiologic microorganisms were identified, among which E. coli was the most common (91.7%). Antibiotic sensitivity of the isolated E. coli strains were as follows; 29.8% to ampicillin, 44.2% to trimethoprim/sulfamethoxazol, 75% to ciprofloxacin, 86.8% to cefazolin and 99.2% to amikacin. CONCLUSION: E. coli was the most common pathogen of community-acquired APN. Ampicillin, trimethoprim/sulfamethoxazol and cephalothin are inappropriate for its empirical therapy. Ciprofloxacin, 3rd generation cephalosporins and aminoglycosides are effective as the first-line empirical agent.
