Retrospective Comparison of Clinical  Characteristics and In-Hospital Outcomes  among Diabetic and Non-Diabetic Adults  with Acute Pyelonephritis

Trivedi, Shailesh; Phatak, Sanjeev; Trivedi, Renu S

doi:10.7860/jcdr/2016/22830.8720

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…CRP levels in pyelonephritis were often greater than 200 mg/L and were not affected by the presence of diabetes (India). 35 CRP levels in lower urinary tract infection (UTI) were not altered by pregnancy (Cameroon). 36 In males admitted with UTI the median CRP level was 22.3 mg/L (India).…”

Section: Resultsmentioning

confidence: 99%

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

Lamrous

Repetto

Depp

et al. 2023

JAC-Antimicrobial Resistance

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Objectives C-reactive protein (CRP) and procalcitonin (PCT) are widely used biomarkers in high-income countries. However, evidence for their use in low- and middle-income countries (LMICs) is scant. Because many factors, including rates of endemic disease, comorbidities and genetics, may influence biomarkers’ behaviour, we aimed to review available evidence generated in LMICs. Methods We searched the PubMed database for relevant studies within the last 20 years that originated in regions of interest (Africa, Latin America, Middle East, South Asia or South East Asia), and full-text articles involving diagnosis, prognostication and evaluation of therapeutic response with CRP and/or PCT in adults (n = 88) were reviewed and categorized in 12 predefined focus areas. Results Overall, results were highly heterogeneous, at times conflicting, and often lacking clinically useful cut-off values. However, most studies demonstrated higher levels of CRP/PCT in patients with bacterial versus other infections. HIV and TB patients had consistently higher levels of CRP/PCT versus controls. In addition, higher CRP/PCT levels at baseline and follow-up in HIV, TB, sepsis and respiratory tract infections were associated with poorer prognosis. Conclusions Evidence generated from LMIC cohorts suggests that CRP and PCT may have potential to become effective clinical guiding tools particularly in respiratory tract infections, sepsis and HIV/TB. However, more studies are needed to define potential scenarios for use and cost-effectiveness. Consensus across stakeholders regarding target conditions, laboratory standards and cut-off values would support the quality and applicability of future evidence.

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Section: Resultsmentioning

confidence: 99%

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

Lamrous

Repetto

Depp

et al. 2023

JAC-Antimicrobial Resistance

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“…Trivedi et al compararon la PNA en pacientes con y sin DM, y observaron que tenían características clínicas similares. Si bien la DM es un FR para el desarrollo y la progresión de la PNA, faltan estudios que comparen las características clínicas y los resultados entre personas con y sin DM 14 . En un reporte de un caso publicado en 2016 se presentó una mujer de 62 años con DM, PNA y espondilitis causada por Salmonella typhi; la infección podría ser resultado de la presencia de neuropatía diabética pues presentaba vejiga neurogénica e hidronefrosis.…”

Section: Pielonefritisunclassified

Pielonefritis y nefritis intersticial

Medek¹

2023

Rev. Soc. Argent. Diabetes

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La pielonefritis aguda es una infección frecuente que puede progresar a absceso o pielonefritis enfisematosa (PE) la mayoría de los casos se produce por Escherichia coli. La presentación clínica puede oscilar desde síntomas leves hasta septicemia. La posibilidad de bacteremia depende de factores del huésped: pacientes que gravemente enfermos, inmunocomprometidos, con obstrucción del tracto urinario y mayores de 65 años. Más del 90% de PE se presenta en pacientes con diabetes. La nefritis intersticial afecta el intersticio renal, puede ser aguda o crónica, la mayoría de las veces debido a AINES o antibióticos. Ambas patologías son predominantes en mujeres.

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“…5,[10][11][12][13] Another study suggested that the clinical features of acute pyelonephritis did not differ between diabetic and non-diabetic patients, and there was no difference in hospital stay between both groups. 14 Increases in mean platelet volume (MPV) have been suggested to be a predictor for the diagnosis of acute urinary tract infection in children, 15 but other studies have shown no significant association. 16 Uncomplicated acute pyelonephritis patients can be managed in the EMW.…”

Section: Introductionmentioning

confidence: 99%

“…Those risk factors include being elderly (age > 65 years), male sex, bedbound patients, diabetes mellitus, immunosuppressed patients, healthcare‐associated infection, obstructive uropathy, reduced platelet count, reduced serum albumin level, increased C‐reactive protein (CRP) level, bacteraemia and first episode of acute complicated pyelonephritis 5 , 10–13 . Another study suggested that the clinical features of acute pyelonephritis did not differ between diabetic and non‐diabetic patients, and there was no difference in hospital stay between both groups 14 . Increases in mean platelet volume (MPV) have been suggested to be a predictor for the diagnosis of acute urinary tract infection in children, 15 but other studies have shown no significant association 16 …”

Section: Introductionmentioning

confidence: 99%

Predictive factors for prolonged hospitalisation in acute pyelonephritis patients admitted to the emergency medicine ward

Chan

Leung

Law

et al. 2021

Hong Kong Journal of Emergency Medicine

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Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.

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Retrospective Comparison of Clinical Characteristics and In-Hospital Outcomes among Diabetic and Non-Diabetic Adults with Acute Pyelonephritis

Cited by 3 publications

References 17 publications

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review

Pielonefritis y nefritis intersticial

Predictive factors for prolonged hospitalisation in acute pyelonephritis patients admitted to the emergency medicine ward

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