Login to Access Video or Poster Abstract: MP23-08
Sources of Funding: none

Introduction

To access the risk factor for recurrent urinary tract infection (UTI) in urinary stone patients with acute obstructive pyelonephritis (OPN).

Methods

We retrospectively reviewed the medical records of 52 patients who had urinary tract stone with acute OPN from 2010-2015. After treatment, patients who admitted to the department of urology or nephrology via emergency room within 1 year were included. Multivariate analysis were performed to identify the risk factors.

Results

Mean age of patients was 62.2±14.6 years and mean follow-up duration was 26.0±20.39 months. E-coli was dominating organism (68.1%, 15/22) in initial urine culture. After infection control and stone management, 23 patients showed recurrent UTI during follow-up. Of them, 43.5% (10/23) patients were re-admitted because of UTI within 1 month after initial treatment. Patients were divided to two groups (recurrent UTI group (n=23), non-recurrent UTI group (n=29). Between groups, significant differences were found in diabetes history (47.8% vs. 17.2%, p=0.018), stone location (kidney, recurrent group 63.0% vs. non-recurrent group 24.0%, p=0.031) and initial positive urine culture (55.6% vs. 28.0%, p=0.016, table 1). In multivariate analysis, initial urine culture (positive, p=0.040, 95% confidence interval (CI), 1.130-224.117) was identified as independent risk factor for recurrent UTI. Of recurrent UTI group, 14(60.9%) patients showed positive urine cultures which were newly diagnosed or different with initial urine culture. In multivariate analysis, acute renal insufficiency at initial laboratory test (p=0.019, 95% CI 1.375-36.157) and stone location (kidney, p=0.022, 95% CI, 1.345-46.926) were significant factors associated with newly diagnosis positive urine culture (table 2).

Conclusions

Initial positive urine culture was significant risk factor for recurrent UTI in urinary stone patients with acute OPN. And caution is also needed in patients with acute renal insufficiency or renal stone during follow up

Funding

none