Urogenit Tract Infect.  2017 Aug;12(2):82-88. 10.14777/uti.2017.12.2.82.

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

• Lee SW
• Yoon S
• Do J
• Seo DH
• Lee C
• Jeh SU
• Choi SM
• Kam SC
• Hwa JS
• Chung KH
• Hyun JS

• KMID: 2389574
• DOI: http://doi.org/10.14777/uti.2017.12.2.82

Abstract

PURPOSE
To identify and evaluate the risk factors for the development of recurrent febrile urinary tract infection (fUTI) among patients with previous urinary stone and acute obstructive pyelonephritis (OPN).
MATERIALS AND METHODS
We retrospectively reviewed the medical records of 52 patients, who had urinary tract stones presented with OPN, between 2010 and 2015. Following their initial treatment, patients who were subsequently admitted with fUTI were included.
RESULTS
The mean age of patients was 62.2±14.6 years, and the mean follow-up duration was 26.0±20.39 months. Escherichia coli was found to be the dominating organism (68.2%, 15/22) in the initial urine culture. Patients were divided into two groups: The recurrent fUTI group (n=23) and the non-recurrent fUTI group (n=29). Between these two groups, significant differences were found with respect to diabetes history (recurrent group: 47.8% vs. non-recurrent group; 17.2%, p=0.018), stone location (kidney, 60.9% vs. ureter, 31.0%, p=0.031), and initially positive urine culture (60.9% vs. 27.6%, p=0.016). In a multivariate analysis, having an initially positive urine culture (95% confidence interval, 1.130-224.117; p=0.040) was identified as being an independent risk factor for developing recurrent fUTI. In a multivariate analysis, the initial laboratory test finding of acute renal insufficiency (ARI, p=0.019) and presence of a kidney stone (p=0.022) were significant factors associated with a newly-diagnosed-positive urine culture diagnosis.
CONCLUSIONS
Having an initially positive urine culture was a significant risk factor for the development of recurrent fUTI in urinary stone patients with acute OPN. In addition, repeated urine tests were also needed in patients with ARI or renal stones during the follow-up period.

Keyword

Urinary calculi; Urinary tract infections; Pyelonephritis

MeSH Terms

Acute Kidney Injury
Diagnosis
Escherichia coli
Follow-Up Studies
Humans
Kidney Calculi
Medical Records
Multivariate Analysis
Pyelonephritis*
Retrospective Studies
Risk Factors*
Ureter
Urinary Calculi*
Urinary Tract Infections*
Urinary Tract*

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