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Abstract

Vol.61 No.3 May 2013

Clinical studies on acute pyelonephritis caused by urolithiasis at Oji General Hospital

Yoshiki Hiyama1), Satoshi Takahashi2), Yuichiro Kurimura1), Kohji Ichihara2), Jiro Hashimoto2) and Keisuke Taguchi1)

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