Korean J Nephrol.
2002 Nov;21(6):905-913.
A Study on the Clinical and Microbiologic Features of Community-acquired Acute Pyelonephritis for the Recent 5 Years in a University Hospital
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea. ohchris@hanmail.net
- 2Department of Clinical Pathology, College of Medicine, Hallym University, Seoul, Korea.
Abstract
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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.
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