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KMID : 0388420020120010065
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Konkuk Journal of Medical Sciences
2002 Volume.12 No. 1 p.65 ~ p.74
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Clinical Features and Antibiotic Resistance of Acute Pyelonephritis
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Kim Jung-Su
Jo Young-Il
Song Jong-Oh
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Abstract
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Acute pyelonephritis(APN) is defined as a symptomatic bacterial infection of the upper urinary tract. The diagnosis of APN may be difficult due to the lack of symptoms or to a atypical manifestations and its delayed treatment may lead to sepsis. Therapy of APN needs empirical antibiotic treatment and it is very important to choose appropria4kee sensitive antibiotics. The authors thereby studied clinical features and diagnostic criteria of APN and compared the relationship between the result of culture positive and several clinical parameters. And also studied sensitivity rate of various antibiotics to cultured bacteria. APN was a disease of female. The 161 cases of total 175 cases were female. Most common clinical manifestation was fever and chills(89%). Costovertebral angle tenderness(69%), flank pain(60%, nausea(39%), vomiting(35%), dysuria(31%) were frequently observed clinical . manifestations. Positive results of urine culture was statistically related to urine nitrite(p=0.001), systemic leukocytosis(p=0.023) and positive urine leukocytes(p=0.001). High positive rate(70%) and strong relation with culture positive made urine leukocytes as a reliable diagnostic parameter. Most commonly cultured bacteria was Escherichia coli(78.9%). Sensitive antibiotics to Gram negative bacteria were amikacin(98%), cefoxitin(93%), cefuroxime (92%), ceftriaxone(93%), timentin(93%), ciprofloxacine(92%), ofloxacine(93%). Ampicillin sensitivity to Gram negative bacteria was only 39%. Most effective antibiotic combinations for treatment of APN seemed intravenous second generation cephalosporine and aminoglycoside and following oral quinolone.
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KEYWORD
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Acute Pyelonephritis, antibiotics, resistance
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