Infectious Disease Unit, Department of Internal Medicine, Infectious Disease Unit, University Hospital of Heraklion, 71 110, Heraklion, Crete, Greece.
J Am Geriatr Soc. 2009 Nov;57(11):2125-8. doi: 10.1111/j.1532-5415.2009.02550.x.
To study potential differences in the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis with and without diabetes mellitus.
Retrospective review of medical records.
University hospital.
Eighty-eight patients aged 65 and older with diabetes mellitus (DM) (57 female; 64.8%) and 118 controls without DM (75 female; 63.6%), matched for age and sex, hospitalized with acute pyelonephritis between January 1997 and December 2005.
Medical records were reviewed for demographic, clinical, and microbiological characteristics.
The median age of both groups was 74 (range 65-95). Twenty-seven people with DM (30.7%) and 13 controls (11.0%) had bacteremia (P=.001). People with DM had longer fever (median 4.5 vs 2.5 days; P<.001), longer hospitalization (median 10 vs 7 days; P<.001), and greater mortality (12.5% vs 2.5%; P<.01) than controls. Logistic regression analysis proved DM to be an independent predictor of bacteremia, long hospitalization, and mortality. Escherichia coli was the most common microorganism found in both groups, whereas Candida spp. were implicated more frequently in people with DM than controls (12.7% vs 1.7%; P<.01). Antimicrobial resistance did not increase over the study period.
Acute pyelonephritis in elderly people with DM is associated with risk of bacteremia, long hospitalization, and mortality.
研究伴有和不伴有糖尿病的老年住院患者急性肾盂肾炎的临床和微生物学特征的潜在差异。
病历回顾性分析。
大学医院。
1997 年 1 月至 2005 年 12 月期间因急性肾盂肾炎住院的 88 名年龄在 65 岁及以上的糖尿病（DM）患者（57 名女性；64.8%）和 118 名年龄和性别相匹配的无 DM 对照者（75 名女性；63.6%）。
回顾了病历以获取人口统计学、临床和微生物学特征。
两组的中位年龄均为 74 岁（范围 65-95 岁）。27 名 DM 患者（30.7%）和 13 名对照者（11.0%）有菌血症（P=.001）。DM 患者发热时间更长（中位数 4.5 天比 2.5 天；P<.001）、住院时间更长（中位数 10 天比 7 天；P<.001）和死亡率更高（12.5%比 2.5%；P<.01）。Logistic 回归分析证明 DM 是菌血症、住院时间延长和死亡率的独立预测因素。两组最常见的微生物均为大肠埃希菌，而念珠菌属在 DM 患者中比对照者更为常见（12.7%比 1.7%；P<.01）。研究期间，抗菌药物耐药性没有增加。
老年糖尿病患者的急性肾盂肾炎与菌血症、住院时间延长和死亡率的风险相关。
