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

Yeonjae Kim, Seong Heon Wie, U. Im Chang, Jieun Kim, Moran Ki, Young Kyun Cho, Seung Kwan Lim, Jin Seo Lee, Ki Tae Kwon, Hyuck Lee, Hee-Jin Cheong, Dae Won Park, Seong Yeol Ryu, Moon Hyun Chung, Hyunjoo Pai

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives: Purpose of this study was to compare clinical characteristics and treatment outcomes in diabetic and non-diabetic women with community-acquired APN (CA-APN). 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=0.009), symptoms of lower urinary tract infection (57.3% vs. 69.6% P=0.001) and costovertebral angle tenderness (54.9% vs. 72.2% P<0.001). However, more of them had C-reactive protein ≥20mg/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=0.169; 2.0% vs. 1.7%, P=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 1.1-2.7, P=0.011), together with nausea/vomiting, history of admission within 1 year, bacteremia, azotemia, and dementia, as well as extended-spectrum β-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.

Original languageEnglish
Pages (from-to)244-251
Number of pages8
JournalJournal of Infection
Volume69
Issue number3
DOIs
Publication statusPublished - 2014 Jan 1

    Fingerprint

Keywords

  • Acute pyelonephritis
  • Diabetes mellitus
  • Women

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Kim, Y., Wie, S. H., Chang, U. I., Kim, J., Ki, M., Cho, Y. K., Lim, S. K., Lee, J. S., Kwon, K. T., Lee, H., Cheong, H-J., Park, D. W., Ryu, S. Y., Chung, M. H., & Pai, H. (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. https://doi.org/10.1016/j.jinf.2014.05.002