Yamamichi Fukashi, Shigemura Katsumi, Kitagawa Koichi, Takaba Kei, Tokimatsu Issei, Arakawa Soichi, Fujisawa Masato
Division of Urology, Department of Organ Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Urology, Department of Organ Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan; Department of International Health Sciences, Kobe, Japan; Infecion Control and Prevention, Kobe University Hospital, Kobe, Japan.
Can Urol Assoc J. 2017 Mar-Apr;11(3-4):E105-E109. doi: 10.5489/cuaj.4097. Epub 2017 Mar 16.
Urosepsis is a severe infection that can cause shock afterwards. The purpose of this study is to investigate the clinical and bacterial risk factors for shock in those cases with urosepsis caused by urinary tract infection in a multicentre study.
Our study included 77 consecutive urosepsis cases from four hospitals We examined factors such as patient characteristics, underlying disease, serum white blood cell (WBC) count, platelet count, C-reactive protein (CRP) level at the time of diagnosis of urosepsis, urinary tract occlusion, causative bacteria, and bacterial antibiotic susceptibilities. Statistical analyses were performed to assess the potential risk factors for shock during the clinical course of urosepsis by a multivariate analysis.
We had 38 male and 39 female patients aged 25-104 (median 73). Underlying diseases included cancers (n=22, 28.6 %) and diabetes mellitus (n=17, 22.1 %). Positive blood culture was seen in 74 cases; these involved 88 bacterial strains, of which was the most common (34 strains, 38.6 %). There were 31 cases with shock (40.3 %) and multivariate analyses demonstrated that serum CRP was the only clinical risk factor for shock due to urosepsis.
Our study demonstrated that serum CRP was a risk factor for shock during urosepsis in a multicentre analysis. Further prospective studies with a greater number of patients are needed to draw more definitive conclusions.
泌尿道脓毒症是一种严重感染，可随后导致休克。本研究的目的是在一项多中心研究中调查由尿路感染引起的泌尿道脓毒症患者发生休克的临床和细菌学危险因素。
我们的研究纳入了来自四家医院的77例连续的泌尿道脓毒症病例。我们检查了患者特征、基础疾病、血清白细胞（WBC）计数、血小板计数、泌尿道脓毒症诊断时的C反应蛋白（CRP）水平、尿路梗阻、致病菌及细菌抗生素敏感性等因素。通过多变量分析进行统计分析，以评估泌尿道脓毒症临床过程中发生休克的潜在危险因素。
我们有38例男性和39例女性患者，年龄在25至104岁之间（中位数73岁）。基础疾病包括癌症（n = 22，28.6%）和糖尿病（n = 17，22.1%）。74例血培养呈阳性；共涉及88株细菌，其中[未提及具体细菌名称]最为常见（34株，38.6%）。有31例发生休克（40.3%），多变量分析表明血清CRP是泌尿道脓毒症所致休克的唯一临床危险因素。
我们的研究表明，在一项多中心分析中，血清CRP是泌尿道脓毒症期间发生休克的一个危险因素。需要进行更多患者参与的进一步前瞻性研究以得出更明确的结论。
