The influence of chronic renal failure on the spectrum and antimicrobial susceptibility of uropathogens in community-acquired acute pyelonephritis presenting as a positive urine culture

BMC Infect Dis. 2011 Apr 21:11:102. doi: 10.1186/1471-2334-11-102.

Abstract

Background: The role of chronic renal failure (CRF) in the antimicrobial resistance of uropathogens in patients with community-acquired acute pyelonephritis (APN) remains poorly understood.

Method: We performed a retrospective analysis of 502 adults (54 men, 448 women; mean age 61.7 ± 16.0 years, range 18-98 years) who were treated for community-acquired APN at Kosin University Gospel Hospital (Busan, Republic of Korea) during a ten-year period (January 2000 to December 2009). We evaluated the spectra and antimicrobial susceptibility profiles of uropathogens in CRF and non-CRF patients with community-acquired APN that presented as a positive urine culture.

Results: The 502 adult subjects were classified as either non-CRF APN patients (336 patients, 66.9%) or CRF APN patients (166 patients, 33.1%) according to their estimated glomerular filtration rate. No significant differences in the sensitivity of E. coli to a third cephalosporin, aminoglycoside (except gentamycin), or ciprofloxacin were observed between non-CRF and CRF patients.

Conclusions: In our series of patients with community-acquired APN that initially presented as a positive urine culture, CRF did not influence the isolation rates of different uropathogens or their patterns of susceptibility to antimicrobials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / microbiology
  • Culture Media
  • Escherichia coli / drug effects
  • Escherichia coli / isolation & purification
  • Female
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / drug effects*
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Kidney Failure, Chronic / complications*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Pyelonephritis / complications*
  • Pyelonephritis / microbiology
  • Republic of Korea
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / microbiology
  • Urine / microbiology*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Culture Media