Impact of ESBL‑producing bacteria on patients with acute pyelonephritis: A study based on patient data from a single hospital
- Seong-Ji Park
- In-Beom Jeong
- Won-Min Hwang
- Sung-Ro Yun
- Se-Hee Yoon
Affiliations: Department of Internal Medicine, College of Medicine, Konyang University Myunggok Medical Research Institute, Daejeon 35365, Republic of Korea
- Published online on: June 24, 2021 https://doi.org/10.3892/wasj.2021.113
Copyright: © Park
et al. This is an open access article distributed under the
terms of Creative
Commons Attribution License.
Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
This article is mentioned in:
The present study investigated the microbial etiologies and clinical impact of extended‑spectrum β‑lactamase (ESBL)‑producing bacteria according to urine and blood cultures from patients with acute pyelonephritis (APN). Data of all patients (age >15 years) who had been hospitalized at a single hospital with APN were collected between January, 2010 and December, 2018. Overall, 882 patients with APN were included. Patients were divided into an ESBL‑producing and non‑ESBL‑producing group. In addition, each group was further stratified in accordance with positive ESBL cultures from a urine sample (U‑ESBL group and U‑non‑ESBL group) or from either blood or urine samples (UB‑ESBL group and UB‑non‑ESBL group). In 651 (74%) of these cases, bacteria were isolated from either urine or blood samples. The prevalence of ESBL‑producing bacteria from either urine or blood samples (UB‑ESBL) was found to steadily increase over the 9‑year study period from 6.3 to 37.8%. The male sex [odds ratio (OR), 2.572; 95% confidence interval (CI), 1.295‑5.108] and previous antibiotic exposure (OR, 2.275; 95% CI, 1.105‑4.680) were significant risk factors for UB‑ESBL in the multivariable analysis. The patients in the UB‑ESBL group exhibited a significantly higher mortality rate (OR, 1.654; 95% CI, 1.106‑2.474) and a higher continuous renal replacement therapy (CRRT) rate. By multivariable analysis, UB‑ESBL and not U‑ESBL was an independent prognostic indicator for mortality and recurrence. Consequently, the use of carbapenems as a first‑line therapy for APN is expected to rapidly increase, and there is concern regarding the emergence of new antibiotic‑resistance bacteria. Global efforts to reduce resistance bacteria and the development of novel treatment methods other than the use of antibiotics to treat bacteria are urgently required. In addition, the results of the present study emphasize the importance of blood culture tests, as well as urine culture tests for the successful treatment of APN.