title: Corinebacterium urealyticum: increased incidence of infection and encrusted uropathy.
abstract: BACKGROUND
  Corynebacterium urealyticum (CU) affects patients who are immunosuppressed, chronically ill or have undergone numerous operations. Obstructive uropathy (OU) is a complication of infection.
  
  
  OBJECTIVE
  To demonstrate the growing increase in cases of infection by CU and OU in the past 5 years.
  
  
  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.
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España. Electronic address: fsanchez@fundacio-puigvert.es.
authors.forename: F M
authors.initials: FM
authors.lastname: Sánchez-Martín
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: J M
authors.initials: JM
authors.lastname: López-Martínez
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Kanashiro-Azabache
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Moncada
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: O
authors.initials: O
authors.lastname: Angerri-Feu
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Millán-Rodríguez
authors.affiliation: Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors.forename: H
authors.initials: H
authors.lastname: Villavicencio-Mavrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003354:Corynebacterium Infections / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D014517:Ureteral Obstruction / Q000453:epidemiology* / Q000209:etiology*; D014552:Urinary Tract Infections / Q000150:complications* / Q000453:epidemiology*; D055815:Young Adult
keywords: Acidifying therapy; Incidence; Incidencia; Infección Urinaria; Obstructive uropathy; Pielitis; Pyelitis; Tract urinary infectión; Tratamiento acidificante; Uropatía incrustante