A Study on the Clinical and Microbiologic Features of Community-acquired Acute Pyelonephritis for the Recent 5 Years in a University Hospital / 대한신장학회잡지

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.