Corinebacterium urealyticum: increased incidence of infection and encrusted uropathy
Autor: | A. Kanashiro-Azabache, E. Moncada, O. Angerri-Feu, H. Villavicencio-Mavrich, F.M. Sánchez-Martín, F. Millán-Rodríguez, J.M. López-Martínez |
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Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Corynebacterium urealyticum 030106 microbiology ved/biology.organism_classification_rank.species 030232 urology & nephrology Renal function Urine Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Young adult Obstructive uropathy business.industry ved/biology Incidence Incidence (epidemiology) Acidifying therapy Multimodal therapy General Medicine Tract urinary infection medicine.disease Surgery Pyelitis business Complication |
Zdroj: | Actas Urologicas Espanolas r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
ISSN: | 2173-5786 0210-4806 |
Popis: | Introduction: Corynebacterium urealyticum (CU) affects patients who are immunosuppressed, chronically ill or have undergone numerous operations. Obstructive uropathy (OU) is a complication of infection. Study objective: To demonstrate the growing increase in cases of infection by CU and OU in the past 5 years. Material and methods: A descriptive study was conducted of urological patients with CU positive urine cultures (January 2009-December 2014). We calculated the annual distribution and clinical characteristics of infection by CU and OU. Minimum follow-up: 6 months. We obtained the statistical means and ranges of clinical parameters pre/post-therapy. Results: The total number of patients with CU was 115 (men, 87; women, 28). The mean age was 67.9 years (range, 6-95 years), and the annual distribution of cases for 2009, 2010, 2011, 2012, 2013 and 2014 was 9 (7.8%), 13 (11.3%), 9 (7.8%), 20 (17.4%), 31 (27%) and 33 (28.7%), respectively. The increase in cases for 2009-2014 was 300%. Multiple urological surgeries were performed in 89 cases (77.3%), with surgical complications in 77 cases (66.9%). Eighteen (15.6%) patients had OU (men, 13; women, 5), 12 had pyelitis (66.7%), 3 had cystopathy (16.6%), 2 had prostatic capsule disease (11.2%) and 1 had mesh calcification (5.5%). The analysis of the 18 cases with OU showed pre/postantibiotic therapy urine pHs of 8 (r, 6-9) vs. 6 (r, 5-7). All postantibiotic cultures were negative. Acidifying solution was applied in 5 cases, and surgery was performed in 13 cases (72.2%). The results from before/after the multimodal therapy showed renal impairment in 12 (66.6%) vs. 9 cases (50%) and glomerular filtration rates (GFR) of 45.8 (r, 6- > 90) vs. 52.7 (r, 13- > 90). The improvement in GFR was 6.94 points (T Wilcoxon; P = .102). The radiology results (incrustations) showed improvement in 13 patients (72.2%) and no change in 5 (27.8%). There was no specific mortality for CU. Conclusions: The prevalence of infection by CU and OU is increasing. Antibiotic treatment is highly effective. Acidifying solutions are an acceptable option for reducing calcifications. (C) 2015 AEU. Published by Elsevier Espana, S.L.U. All rights reserved. |
Databáze: | OpenAIRE |
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