Predictors of ultrasound abnormalities among women treated for community-onset acute pyelonephritis: a prospective study

Objectives Acute pyelonephritis (AP) is a common but potentially severe infection. It may be complicated by pyelocaliceal dilatation which requires emergency urine drainage. In outpatient care, ultrasound (US) appears to be the easier way to diagnose pyelocaliceal dilatation, though most APs will no...

Full description

Saved in:
Bibliographic Details
Published in:World journal of urology 2022-10, Vol.40 (10), p.2499-2504
Main Authors: Bruyère, Franck, Conan, Yoann, Vallée, Maxime, Gaborit, Christophe, Crespin, Hugo, Ruimy, Joseph-Alain, Sotto, Albert, Grammatico-Guillon, Leslie
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives Acute pyelonephritis (AP) is a common but potentially severe infection. It may be complicated by pyelocaliceal dilatation which requires emergency urine drainage. In outpatient care, ultrasound (US) appears to be the easier way to diagnose pyelocaliceal dilatation, though most APs will not be complicated and do not require immediate ultrasound. We aimed to identify predictors of ultrasound abnormalities in an outpatient AP cohort. Methods A prospective study was conducted from April 2006 to September 2019 in an outpatient care network. Patients aged 15 and over treated for AP were included. Men, pregnant women, patients with solitary kidney, and patients without data on their management were excluded. A common algorithm ensured the same approach from diagnosis to treatment. Data were collected prospectively in an anonymized database. We described the characteristics of the patients. Univariate and then multivariate analyses were performed to identify predictors of ultrasound abnormalities. Results 2054 women were treated for AP. Among them, 32.5% ( n  = 667) had a history of urinary tract infections and 5.8% ( n  = 120) of uropathy. The most frequent uropathogen was E. coli ( n  = 1,432; 69.7%); Extended-Spectrum Beta-Lactamases (ESBLs) were found in 39 (1.9%) urine cultures. Ultrasound was abnormal in 7.3% ( n  = 149). Age over 55 years (OR = 2.23; 95% CI 1.58‒3.15; p 
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-022-04112-1