Complicated urinary tract infection caused by Pseudomonas aeruginosa in a single institution (1999-2003).
BACKGROUND
Pseudomonas aeruginosa has been an important uropathogen that causes complicated urinary tract infection. We investigated the clinical characteristics of complicated urinary tract infection caused by Pseudomonas aeruginosa in a single institution.


METHODS
We studied those patients who had basal disease in their urinary tract that was diagnosed as urinary tract infection caused by more than 10(4) colony forming units (CFU)/mL of Pseudomonas aeruginosa isolated from their urine. In those patients, we analysed infectious risk factors, treatment methods including the use of antimicrobial agents, the presence of a urinary tract catheter, and the relationship between febrile infection and urinary tract catheter. In addition, we examined the various antimicrobial susceptibilities against Pseudomonas aeruginosa.


RESULTS
We studied 76 patients (59 men and 17 women). Of their basal diseases of the urinary tract, bladder tumor was the most prevalent (42.1%). Of the 39 patients who had an indwelling urinary tract catheter, 26 (66.7%) experienced a high-grade fever, a higher rate than that of the 37 patients who were not catheterized (40.5%). Seven patients were treated with anticancer chemotherapy drugs and 31 cases of urinary tract infection caused by Pseudomonas aeruginosa were diagnosed in the perioperative period. Piperacillin showed lower susceptibility against Pseudomonas aeruginosa in these 2 years (P<0.05).


CONCLUSIONS
Our results indicated that those patients with urinary tract catheterization had a higher incidence of fever than patients without catheterization. Therefore, we must improve not only the antimicrobial treatment of Pseudomonas aeruginosa but also our management of catheters.
Shigemura
Katsumi
K
Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, and Clinical Laboratory, Kobe University Hospital, Japan.
Arakawa
Soichi
S
Sakai
Yutaka
Y
Kinoshita
Shohiro
S
Tanaka
Kazushi
K
Fujisawa
Masato
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification / Q000502:physiology*; D013997:Time Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*
D000900:Anti-Bacterial Agents