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KMID : 0378019820250060119
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New Medical Journal
1982 Volume.25 No. 6 p.119 ~ p.128
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Clinical Observation on Acute Pyelonephritis
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Abstract
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A clinical observation was made on two hundred and six cases of acute pyelonephritis patients who have been admitted to Kyungpook University Hospital for the past three and a half years. The following results were obtained:
The highest age of incidence of acute phylonephritis was the 3rd decade (35.4%), followed by the 4th decade (17.0%), and the 5th decade (16.5%) in that order of frequency. 68.9% of the cases ocurred in female patients 20-40 years of age. The sex ratio was i to 7.2 with female predominence.
Predisposing factors were recognized in 44.2% of the total cases. The major predisposing factors were pregnancy (15.0%), obstructive uropathy (7.3%) , urinary tract anomaly (6.31´16), instrumentation (5.3%) and diabetes mellitus (5.3%) . The most common clinical symptoms were fever and chills (93.2%6), CVA tenderness (62.1%) , followed by flank pain (51.5%) , dysuria (31.6%) and nausea and vomiting (29.6%) in that order of frequency. In urinary findings most of the patienst (94.2%) had pyuria exceeding 5 leukocytes and one third had greater than 5 erythrocytes per high power field and a milk degree of proteinuria was present in three-fourths of the total cases.
The number of positive results in urine cultures was 150 of 206 cases (72.8%) with the most common causative microorganism being E. coli (74.0%) , followed by Enterobacter (10.0%) Staphylococcus (4.7%) , Pseudomonas (2.7%) , Proteus (2.7%) and Citrobacter (2.0%) . The most common microorganism in females was E. coli (77.2%) and next to E. coli (56.5%) was Staphylococcus (15%) in males. Mixed infection was observed in 14 cases (9.3%) of a total 206 patients.
Sensitivity of causative organisms to various antibiotics in vitro, E. coli was highly sensitive to gentamicin (84.6%) , amikacin (82.0%), and kanamycin (52.9%). Enterobacter showed a sensitivity to gentamicin (90.0%) and amikacin (87.5%), and Staphylococcus was to cephalosporin, carbenicillin and amikacin.
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