Abstract
Objective
Screening the role of etiological factors and the effects of urological interventions on hospitalization needed febrile urinary tract infections.
Materials and Methods
We retrospectively screened 162 (54%) men and 138 (46%) women, totally 300 patients who referred to urology policlinic with febrile urinary tract infections. We also described statistically the effects of clinical and laboratory findings on hospitalization requirement.
Results
142 (47%) of 300 patients who referred to urology policlinic with febrile urinary tract infections were hospitalizated, and also 158 (52%) patients were treated without hospitalization. When the patients screened about urological interventions which are caused febrile urinary tract infections and etiological factors, we figured out that causes have meaningful roles, such as; prostate needle biopsy, pyelonephritis with kidney-stone, endourological interventions, obstructive urological pathologies, neurogenic bladder, vesicoureteral reflux (VUR), urinary stone disease, bladder extrophy. In male patients (57.4%) there were higher requirement of hospitalization than females (35.5%) (p<0.001). Furthermore, positive urinary culture (202/80.7%), the presence of ESBL+ bacteria (77/25.7%) and high fever (>38.5⁰C) are also affected requirement of hospitalization (p<0.001).
Conclusion
Necessity of hospitalization should be kept in mind in patients who referred with febrile urinary tract infections and etiological factors should be researched carefully. Especially, previous urological interventions and pathological factors must be examined in detail, additionally clinical and laboratory findings which signed necessity of hospitalization should be considered.
Keywords
References
- 1. Biering-Sorensen F, Bagi P, Hoiby N. Urinary tract infections in patients with spinal cord lesions: treatment and prevention. Drugs. 2001; 61: 1275-87.2. Hinkel A, Finke W, Bötel U, Gatermann SG, Pannek J. Increasing resistance against antibiotics in bacteria isolated from the lower urinary tract of an outpatient population of spinal cord injury patients. Urol Int. 2004; 73: 143-8.3. Infectıons of the urinary tract, in Campbell-WalshUrology 10th edition 2012.4. Vigil HR, HicklingDR. Urinary tract infection in the neurogenic bladder. Transl Androl Urol.2016;5: 72-87.5. Game X, Castel-Lacanal E, Bentaleb Y, et al.Botulinum toxin A detrusor injections in patients with neurogenic detrusor overactivity significantly decrease the incidense of symptomatic urinary tract infections.Eur Urol.2008;53: 613-8.6. Krebs J, Wöllner J, PannekJ.Riskfactors for symptomatic urinary tract infections in individual swith chronic neurogenic lower urinary tract dysfunction. Spinal Cord.2016;54: 682-6.7. Merritt JL. Residual urine volume: correlate of urinary tract infection in patients with spinal cord injury. Arch Phys Med Rehabil.1981; 62: 558-61.8. Salizman B. Ureteral stents: indications, variations, and complications. Urol Clin North Am.1988; 15: 481.9. Reid G, Sobel JD. Bacterial adherence in the pathogenesis of urinary tract infection: a review. Rev Infect Dis.1987; 9: 470.10. Costerton JW, Cheng KJ, Geesey GG, et al. Bacterial biofilm in natüre and disease. Ann Rev Microbiol. 1987; 41: 435.11. Wagenlehner FME, Wagenlehner C, Schinzel S, Naber KG. Prospective, Randomized, Multicentric, Open Comparative Study on theEfficacy of a Prophylactic Single Dose of 500mg Levofloxacin versus 1920 mg Trimethoprim/Sulfamethoxazole versus a Control Group in Patients Undergoing TUR of the Prostate. Eur Urol.2005; 47: 549-56.12. Colau A, Lucet JC, Rufat P, Botto H, Benoit G, Jardin A. Incidence and risk factors of bacteriuria after transurethral resection of the prostate. Eur Urol.2001; 39: 272-6.13. Carlson WH, Bell DG, Lawen JG, et al. Multi-drug resistant E.Coli urosepsis in physicians following transrectal ultrasound guided prostate biopsies-three cases including one death. Can J Urol. 2010; 17: 5135-7
Abstract
Amaç
Üriner sistem enfeksiyonlarında hospitalizasyon gerektiren etiyolojik faktörlerin ve ürolojik girişimlerin hospitalizasyon gereksinimindeki rolünün araştırılması
Gereç ve Yöntem
Üroloji Polikliniğine ateşli üriner sistem enfeksiyonu nedeniyle başvuran 162 (%54) erkek ve 138 (%46) kadın olmak üzere toplam 300 hastanın etiyolojik faktörlerini retrospektif olarak araştırdık. Ayrıca klinik ve laboratuvar bulgularının da hospitalizasyon gereksinimi üstündeki etkilerini istatistiksel olarak anlamlı şekilde tanımladık.
Bulgular
Üroloji polikliniğine yüksek ateşli üriner sistem enfeksiyonu nedeniyle başvuran 300 hastadan 142(%47.3)'si yatırılarak tedavi edilmiş, bunun yanı sıra 158 (%52.7) hasta ayaktan tedavi ile takip edilmiştir. Hastalarda ateşli enfeksiyona neden olabilecek ürolojik girişimler ve etiyolojik faktörler araştırıldığında; prostat iğne biyopsisi, taşlı piyelonefrit, endo-ürolojik girişimler, obstrüktif ürolojik patolojiler, nörojenik mesane, vezikoüreteral reflü (VUR), üriner sistem taş hastalıkları, ekstrofia vezikale gibi nedenlerin anlamlı olarak rolü olduğu tespit edilmiştir. Erkeklerde (%57.4) kadınlara kıyasla (%35.5) daha fazla hospitalizasyon gereksinimi olduğu görülmektedir (p<0.001). Ayrıca idrar kültürü (IK) pozitifliği(242/ %80.7), ESBL+ bakteri varlığı (77/ %25.7) ve yüksek ateş (>38,5OC) varlığı (99/ %33) da hospitalizasyon gereksinimini anlamlı şekilde etkilemektedir (p<0.001).
Tartışma
Ateşli Üriner sistem enfeksiyonu nedeniyle polikliniğe başvuran hastalarda hospitalizasyon gerekliliği akılda tutulmalı ve altta yatan etiyolojik faktörler detaylı şekilde araştırılmalıdır. Özellikle geçirilmiş ürolojik girişimler ve de patolojik faktörler dikkatlice sorgulanmalı, bunun yanı sıra hospitalizasyon gerekliliğini işaret eden klinik ve laboratuvar bulgular göz önünde bulundurulmalıdır.
Keywords
References
- 1. Biering-Sorensen F, Bagi P, Hoiby N. Urinary tract infections in patients with spinal cord lesions: treatment and prevention. Drugs. 2001; 61: 1275-87.2. Hinkel A, Finke W, Bötel U, Gatermann SG, Pannek J. Increasing resistance against antibiotics in bacteria isolated from the lower urinary tract of an outpatient population of spinal cord injury patients. Urol Int. 2004; 73: 143-8.3. Infectıons of the urinary tract, in Campbell-WalshUrology 10th edition 2012.4. Vigil HR, HicklingDR. Urinary tract infection in the neurogenic bladder. Transl Androl Urol.2016;5: 72-87.5. Game X, Castel-Lacanal E, Bentaleb Y, et al.Botulinum toxin A detrusor injections in patients with neurogenic detrusor overactivity significantly decrease the incidense of symptomatic urinary tract infections.Eur Urol.2008;53: 613-8.6. Krebs J, Wöllner J, PannekJ.Riskfactors for symptomatic urinary tract infections in individual swith chronic neurogenic lower urinary tract dysfunction. Spinal Cord.2016;54: 682-6.7. Merritt JL. Residual urine volume: correlate of urinary tract infection in patients with spinal cord injury. Arch Phys Med Rehabil.1981; 62: 558-61.8. Salizman B. Ureteral stents: indications, variations, and complications. Urol Clin North Am.1988; 15: 481.9. Reid G, Sobel JD. Bacterial adherence in the pathogenesis of urinary tract infection: a review. Rev Infect Dis.1987; 9: 470.10. Costerton JW, Cheng KJ, Geesey GG, et al. Bacterial biofilm in natüre and disease. Ann Rev Microbiol. 1987; 41: 435.11. Wagenlehner FME, Wagenlehner C, Schinzel S, Naber KG. Prospective, Randomized, Multicentric, Open Comparative Study on theEfficacy of a Prophylactic Single Dose of 500mg Levofloxacin versus 1920 mg Trimethoprim/Sulfamethoxazole versus a Control Group in Patients Undergoing TUR of the Prostate. Eur Urol.2005; 47: 549-56.12. Colau A, Lucet JC, Rufat P, Botto H, Benoit G, Jardin A. Incidence and risk factors of bacteriuria after transurethral resection of the prostate. Eur Urol.2001; 39: 272-6.13. Carlson WH, Bell DG, Lawen JG, et al. Multi-drug resistant E.Coli urosepsis in physicians following transrectal ultrasound guided prostate biopsies-three cases including one death. Can J Urol. 2010; 17: 5135-7
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 28, 2018 |
| Published in Issue | Year 2017 Volume: 2 Issue: 3 |
