Predictors of uropathogens other than Escherichia coli in patients with community-onset acute pyelonephritis
- Authors
- Wi Y.M.[Wi Y.M.]; Kim S.-W.[Kim S.-W.]; Chang H.-H.[Chang H.-H.]; Jung S.-I.[Jung S.-I.]; Kim Y.-S.[Kim Y.-S.]; Cheong H.S.[Cheong H.S.]; Ki H.K.[Ki H.K.]; Son J.S.[Son J.S.]; Kwon K.T.[Kwon K.T.]; Heo S.T.[Heo S.T.]; Yeom J.-S.[Yeom J.-S.]; Ko K.S.[Ko K.S.]; Kang C.I.[Kang C.I.]; Chung D.R.[Chung D.R.]; Peck K.R.[Peck K.R.]; Song J.-H.[Song J.-H.]
- Issue Date
- 2014
- Citation
- International Journal of Clinical Practice, v.68, no.6, pp.749 - 755
- Indexed
- SCIE
SCOPUS
- Journal Title
- International Journal of Clinical Practice
- Volume
- 68
- Number
- 6
- Start Page
- 749
- End Page
- 755
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/56964
- DOI
- 10.1111/ijcp.12368
- ISSN
- 1742-1241
- Abstract
- Aim A constant reduction in the incidence of community-onset acute pyelonephritis (CO-APN) caused by Escherichia coli has been shown with a parallel increase incidence caused by other organisms. Therefore, we evaluated the risk factors and outcome of non-E. coli as uropathogens in patients with community-onset APN. Methods As a part of a nationwide multicentre surveillance study conducted in Korea, a total of 416 patients with CO-APN were collected with their epidemiological, antibiotic treatment and outcome data. Results The risk factors and outcomes of non-E. coli as uropathogens were evaluated in a total of 416 patients with culture-confirmed CO-APN. Non-E. coli caused 127 cases (30.5%) of CO-APN. CO-APN caused by non-E. coli resulted in higher inappropriate empirical therapy (38.6% vs. 20.1%, p < 0.001), longer hospital stay (12.6 days vs. 6.7 days, p = 0.005) and higher 30-day mortality (9.4% vs. 3.8% p = 0.020) compared with CO-APN caused by E. coli. Multivariate analyses showed that male gender (OR, 3.48; CI, 2.13-5.67; p < 0.001), underlying haematological disease (OR, 5.32; CI, 1.17-24.254; p = 0.031), underlying benign prostate hyperplasia (OR, 2.61; CI, 1.02-6.74; p = 0.046), chronic indwelling urethral catheter (OR, 6.34; CI, 1.26-31.84; p = 0.025) and admission history in the previous 6 months (OR, 2.12; CI, 1.23-3.58; p = 0.005) were predictors for CO-APN caused by a non-E. coli isolate. Conclusions Community-onset APN caused by non-E. coli represents a distinct subset of urinary tract infections with worse outcomes. The defined risk factors related with non-E. coli should be taken into consideration when empirical antibiotic therapy is prescribed in patients with community-onset APN. © 2014 John Wiley & Sons Ltd.
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