Vol.61 No.3 May 2013
Clinical studies on acute pyelonephritis caused by urolithiasis at Oji General Hospital
1)Department of Urology, Oji General Hospital
2)Department of Urology, Sapporo Medical University School of Medicine, S1 W16, Chuo-ku, Sapporo, Hokkaido, Japan
Abstract
It is important to know in advance the antimicrobial susceptibility patterns of causative pathogens for patients with severe acute complicated pyelonephritis when we treat such severe urinary tract infections. The purpose of this study was to clarify the causative pathogens for acute pyelonephritis with urinary obstruction due to urinary tract stones and their antimicrobial susceptibilities. In the period from 2008 to 2011, 43 patients diagnosed as having acute pyelonephritis with urinary obstruction due to urinary tract stones were included in this study, and urinary drainage was commonly necessary for the patients. In this study, medical records were reviewed and the data were analyzed retrospectively. The median age of the subjects was 65 years (range: 36 to 89) and the number of female patients was 23. Urinary tract stones were located in the left side in 16 cases, the right side in 24 and both sides in 3. The median size of the urinary tract stones was 9 (2 to 40) mm. As drainage, a ureteral stent (Double-J stent) was inserted in 41 patients, nephrostomy was constructed in 1 and both were done in 1. No patients died of the disease. Pathogens were isolated in 30 of the 43 cases and Escherichia coli, isolated from 15 cases, was predominant among them. There was 1 (7%) strain that was quinolone resistant, and 1 with extended-spectrum beta-lactamase production. In our study, the recommended treatment regimen in the Japanese guidelines was feasible for the patients with acute pyelonephritis with urinary obstruction due to urinary tract stones.
Key word
pyelonephritis, urolithiasis, antimicrobial susceptibility, urinary obstruction
Received
April 1, 2013
Accepted
April 8, 2013
Jpn. J. Chemother. 61 (3): 292-296, 2013
