title: The influence of chronic renal failure on the spectrum and antimicrobial susceptibility of uropathogens in community-acquired acute pyelonephritis presenting as a positive urine culture.
abstract: BACKGROUND
  The role of chronic renal failure (CRF) in the antimicrobial resistance of uropathogens in patients with community-acquired acute pyelonephritis (APN) remains poorly understood.
  
  
  METHODS
  We performed a retrospective analysis of 502 adults (54 men, 448 women; mean age 61.7 ± 16.0 years, range 18-98 years) who were treated for community-acquired APN at Kosin University Gospel Hospital (Busan, Republic of Korea) during a ten-year period (January 2000 to December 2009). We evaluated the spectra and antimicrobial susceptibility profiles of uropathogens in CRF and non-CRF patients with community-acquired APN that presented as a positive urine culture.
  
  
  RESULTS
  The 502 adult subjects were classified as either non-CRF APN patients (336 patients, 66.9%) or CRF APN patients (166 patients, 33.1%) according to their estimated glomerular filtration rate. No significant differences in the sensitivity of E. coli to a third cephalosporin, aminoglycoside (except gentamycin), or ciprofloxacin were observed between non-CRF and CRF patients.
  
  
  CONCLUSIONS
  In our series of patients with community-acquired APN that initially presented as a positive urine culture, CRF did not influence the isolation rates of different uropathogens or their patterns of susceptibility to antimicrobials.
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea.
authors.forename: Yeon Soon
authors.initials: YS
authors.lastname: Jung
authors.forename: Ho Sik
authors.initials: HS
authors.lastname: Shin
authors.forename: Hark
authors.initials: H
authors.lastname: Rim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017714:Community-Acquired Infections / Q000150:complications / Q000382:microbiology; D003470:Culture Media; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications* / Q000382:microbiology; D056910:Republic of Korea; D014552:Urinary Tract Infections / Q000150:complications / Q000382:microbiology; D014556:Urine / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media