Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice.

Autor: Gauhar V; Department of Minimally Invasive Urology, Ng Teng Fong General Hospital, Singapore 609606, Singapore., Robles-Torres JI; Urology Department, Hospital Universitario 'Dr. José Eleuterio González,' Monterrey 64460, Mexico., Wroclawski ML; Department of Urology, Hospital Israelita Albert Einstein, BP-A Beneficência Portuguesa de São Paulo, Sao Paulo 05562-900, SP, Brazil.; Faculdade de Medicina do ABC, Santo André 09060-870, SP, Brazil., Trujillo-Santamaría H; Department of Urology, Hospital Covadonga, Córdoba 94560, Mexico., Teoh JYC; S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China., Tanidir Y; Department of Urology, School of Medicine, Marmara University, Istanbul 34854, Turkey., Mahajan A; Department of Urology, Mahatma Gandhi Mission's Medical College and Hospital, Aurangabad 431003, India., Gadzhiev N; Urology Department, Saint Petersburg State University Hospital, 199034 Saint Petersburg, Russia., Ragoori D; Department Urology, Asian Institute of Nephrology and Urology, Hyderabad 500082, India., Kumar S; Department Urology, Christian Medical College, Vellore 632004, India., Ganpule A; Department of Urology, Muljibhai Patel Urological Hospital, Ahemadabad 387001, India., Maheshwari PN; Department of Urology, Fortis Hospital Mulund, Mumbai 400078, India., García-Chairez LR; Urology Department, Hospital Universitario 'Dr. José Eleuterio González,' Monterrey 64460, Mexico., Enrriquez-Ávila JV; Urology Department, Hospital Universitario 'Dr. José Eleuterio González,' Monterrey 64460, Mexico., Monzón-Falconi JF; Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucatán, Mérdida 97133, Mexico., Esqueda-Mendoza A; Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucatán, Mérdida 97133, Mexico., Flores-Tapia JP; Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucatán, Mérdida 97133, Mexico., Duarte-Santos HO; Department of Urology, Hospital Municipal Dr. Moysés Deutsch (M'Boi Mirim), Sao Paulo 04849-030, SP, Brazil., Farooq M; Department Urology, Christian Medical College, Vellore 632004, India., Arjunrao Gite V; Department Urology, Grant Medical College & Sir JJ hospital, Mumbai 400008, India., Mani Sinha M; Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK., Somani BK; Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK., Castellani D; Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Università Politecnica delle Marche, 60126 Ancona, Italy.
Jazyk: angličtina
Zdroj: Pathogens (Basel, Switzerland) [Pathogens] 2023 May 10; Vol. 12 (5). Date of Electronic Publication: 2023 May 10.
DOI: 10.3390/pathogens12050695
Abstrakt: Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic granulomatous infection of renal parenchyma. XGP is often associated with long-term urinary tract obstruction due to stones and infection. We aimed to analyze the clinical, laboratory, and microbial culture profiles from bladder and kidney urine of patients who were diagnosed with XGP. Databases of patients with histopathological diagnosis of XGP from 10 centers across 5 countries were retrospectively reviewed between 2018 and 2022. Patients with incomplete medical records were excluded. A total of 365 patients were included. There were 228 (62.5%) women. The mean age was 45 ± 14.4 years. The most common comorbidity was chronic kidney disease (71%). Multiple stones were present in 34.5% of cases. Bladder urine culture results were positive in 53.2% of cases. Kidney urine culture was positive in 81.9% of patients. Sepsis and septic shock were present in 13.4% and 6.6% of patients, respectively. Three deaths were reported. Escherichia coli was the most common isolated pathogen in both urine (28.4%) and kidney cultures (42.4%), followed by Proteus mirabilis in bladder urine cultures (6.3%) and Klebsiella pneumoniae (7.6%) in kidney cultures. Extended-spectrum beta-lactamases producing bacteria were reported in 6% of the bladder urine cultures. On multivariable analysis, urosepsis, recurrent urinary tract infections, increased creatinine, and disease extension to perirenal and pararenal space were independent factors associated with positive bladder urine cultures. On multivariable analysis, only the presence of anemia was significantly more frequent in patients with positive kidney cultures. Our results can help urologists counsel XGP patients undergoing nephrectomy.
Databáze: MEDLINE
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