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Jung, Cho, Lee, Lee, Kim, Jeon, Park, Roh, Yang, Sung, Jung, Noh, Chung, Min, Kang, Choi, Kim, Lee, Kim, Lee, Seung, Chang, Song, Lee, Park, Kim, and Kim: Comparative Analysis of Clinical Parameters in Acute Pyelonephritis
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(1): 29-34.

Published online: 31 January 2007

DOI: https://doi.org/10.4111/kju.2007.48.1.29

Comparative Analysis of Clinical Parameters in Acute Pyelonephritis

Yon Hwan Jung, In Rae Cho, Seung Eon Lee, Keon Cheol Lee, Jong Gu Kim, Joon Seong Jeon, Seok San Park, An Sik Roh, Won Jae Yang, Luck Hee Sung, Jae Yong Jung, Choong Hee Noh, Jae Il Chung, Kweon Sik Min, Dong Il Kang, Seung Hyup Choi, Duk Yoon Kim1, Sang Don Lee2, Hong Sup Kim3, Dong Hyun Lee4, Do Hwan Seung5, Young Seop Chang6, Ki Hak Song6, Kyung Seop Lee7, Dong Soo Park8, Young Ho Kim9, Min Eui Kim9

Department of Urology, College of Medicine, Inje University, Gimhae, Korea.

1Department of Urology, Catholic University of Daegu, Daegu, Korea.

2Department of Urology, Pusan National University, Busan, Korea.

3Department of Urology, Konkuk University, Chungju, Korea.

4Department of Urology, Ewha Womans University, Seoul, Korea.

5Department of Urology, Inha University, Incheon, Korea.

6Department of Urology, Konyang University, Daejeon, Korea.

7Department of Urology, Dongkuk University, Gyeongju, Korea.

8Department of Urology, Pochon CHA University, Seongnam, Korea.

9Department of Urology, Sooncheonhyang University, Bucheon, Korea.

Corresponding author (ircho@ilsanpaik.ac.kr)

Received 25 September 2006       Accepted 31 October 2006

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

To compare the variable inflammatory parameters of acute pyelonephritis patients treated with inpatient therapy at 13 hospitals, according to the age and gender distributions.

Materials and Methods

A total of 3,544 medical records of patients with confirmed acute pyelonephritis, and admitted to hospital between January 2000 and December 2005, were retrospectively analyzed.

Results

The mean age of the patients was 43.2±16.2 years old, with a male:female ratio of 1 : 5.1. The average duration of hospital admission was 7.9±5.3 days. Underlying diseases were found in 23.0% (749/3,252 patient), largely due to diabetes (35.1%). Radiological abnormal findings were found in 13.7%. The leukocyte count, ratio of segmented form, erythrocyte sedimentation rate (ESR), c-reactive protein, pyuria, positive blood culture, positive urine culture were 11,014±5,778/mm3, 74.8± 14.5%, 44.0±32.0 mm/hr, 12.4±9.3mg/dl, 83.9%, 10.5% and 46.7%, respectively. E. coli grow in 79% of the urine culture positive patients. In a comparison of 3 age groups (<40 years, 40-60 years, >61 years), the elderly patients had a greater number of underlying diseases and more pathogens in cultured blood. When divided into males and females, the elderly male patients had more pathogen in cultured urine, but contrary to the male patients, the elderly female patients had elevated leukocyte count and erythrocyte sedimentation rate. Also, the old patient group had more resistance to ampicillin when they had E. coli as the uropathogen (p=0.021). Patients with higher ESR required longer hospital admission periods.

Conclusions

It was found that variable clinical parameters of acute pyelonephritis patients treated with inpatient therapy differed according to both gender and age group in Korea. Therefore, these factors should be taken into account in the treatment plan.

Keywords: Acute pyelonephritis, Inpatients

Figures and Tables

Table 1
Gender and age distributions
kju-48-29-i001
Table 2
Comparison of urine/blood culture pathogens according to gender and age distributions
kju-48-29-i002

*: calculated by one-way ANOVA test

Table 3
Clinical parameters and findings according to gender and age distributions
kju-48-29-i003

WBC: white blood cell, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, *: There are rare data of CRP in male patient for statistical analysis.

Table 4
Correlation of inflammatory parameters to admission period
kju-48-29-i004

WBC: white blood cell, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein

Table 5
Uropathogen in acute pyelonephritis patients
kju-48-29-i005
Table 6
Susceptibility of E. coli to antibiotics
kju-48-29-i006

amp: ampicillin, cep: cephazolin, GM: gentamycin, amk: amikacin, cpf: ciprofloxacin, tmp: trimethoprim-sulfamethoxazole, cefot: cefotaxim, oxa: oxacillin, penG: penicillin G, CM: clindamycin, EM: erythromycin, *means statistically significant difference between male and female (p<0.05)

Table 7
Prevalence of antibiotic usage in acute pyelonephritis patients
kju-48-29-i007

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