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Comparison of the clinical characteristics of diabetic and non-diabetic women with community-acquired acute pyelonephritis: A multicenter study

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Author(s)
Yeonjae KimSeong-Heon WieU-Im ChangJieun KimMoran KiYoung Kyun ChoSeung-Kwan LimJin Seo LeeKi Tae KwonHyuck LeeHee Jin CheongDae Won ParkSeong Yeol RyuMoon-Hyun ChungHyunjoo Pai
Keimyung Author(s)
Ryu, Seong Yeol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Infection
Issued Date
2014
Volume
69
Issue
3
Keyword
Acute pyelonephritisDiabetes mellitusWomen
Abstract
Objectives: Purpose of this study was to compare clinical characteristics and treatment outcomes in diabetic and non-diabetic women with community-acquired APN (CAAPN).
Methods: We prospectively collected and analyzed clinical data of women with CA-APN who attended 11 hospitals in South Korea from March 2010 to February 2012.
Results: Of a total of 775 patients, 246 (31.7%) were diabetic and 529 (68.3%) non-diabetic. Fewer of the diabetic patients had flank pain (27.6% vs. 37.2% P Z 0.009), symptoms of lower urinary tract infection (57.3% vs. 69.6% P Z 0.001) and costovertebral angle tenderness (54.9%
vs. 72.2% P < 0.001). However, more of them had C-reactive protein 20 mg/dL (40.7% vs. 27.4% P < 0.001), azotemia (29.3% vs. 13.4% P < 0.001) and bacteremia (53.7% vs. 38.2% P < 0.001). Final clinical failure rates and deaths did not differ between the two groups:
6.9% vs. 4.5%, P Z 0.169; 2.0% vs. 1.7%, P Z 0.747. However, hospitalization was longer in the diabetics than the non-diabetics (median 9.0 days vs. 7.0 days, P < 0.001). In logistic regression, diabetes was independently associated with longer hospitalization (OR 1.7, CI
1.1e2.7, P Z 0.011), together with nausea/vomiting, history of admission within 1 year, bacteremia, azotemia, and dementia, as well as extended-spectrum b-lactamase (ESBL)-positivity and fluoroquinolone resistance of uropathogens.
Conclusions: CA-APN patients with diabetes have more severe disease manifestations and require longer hospitalization than non-diabetic patients although their clinical findings are less clear than those of non-diabetic patients.
Keimyung Author(s)(Kor)
류성열
Publisher
School of Medicine
Citation
Yeonjae Kim et al. (2014). Comparison of the clinical characteristics of diabetic and non-diabetic women with community-acquired acute pyelonephritis: A multicenter study. Journal of Infection, 69(3), 244–251. doi: 10.1016/j.jinf.2014.05.002
Type
Article
ISSN
0163-4453
Source
https://www.sciencedirect.com/science/article/pii/S0163445314001285?via%3Dihub
DOI
10.1016/j.jinf.2014.05.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33789
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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