Xu Meng, Xing Shaoqiang, Zhang Xuefeng, Jiang Yongchao, Chen Yun
Department of Urology, Yantaishan Hospital, Yantai, Shandong, China.
Department of Urology, Tianjin First Central Hospital, Tianjin, China.
PLoS One. 2025 Jun 27;20(6):e0325724. doi: 10.1371/journal.pone.0325724. eCollection 2025.
Patients with febrile upper urinary tract calculi with infection (FUUTCI) are prone to develop or have developed severe infection. This research aimed to evaluate the potential risk factors associated with diabetes mellitus (DM) in patients with FUUTCI.
From September 2018 to December 2023, patients with FUUTCI admitted to our hospital were retrospectively studied. The patients were divided into a diabetic group (n=52) and a non-diabetic group (n=148), and the differences in demographics, etiology, infection indicators on admission, treatment, and outcome between the two groups were compared. Then regression analysis was performed for gender, stone location, occurrence of urinary sepsis, septic shock, use of pressors, bacterial multiresistance, positive fungal culture, and use of two or more antibiotics.
Compared with non-diabetic patients (148 cases, 74.0%), diabetic patients (52 cases, 26.0%) had a higher prevalence of cardiovascular and cerebrovascular diseases (P=0.031), the rate of using two or more antibiotics (P=0.029), the positive rate of yeast culture (P=0.037), the procalcitonin value of admission or emergency (P=0.022). There was a significant difference in stone location (P=0.039). Regression analysis showed that DM was an independent risk factor for febrile urinary tract infection in patients with kidney stones compared to patients with ureteral stones (P=0.032).
In patients with FUUTCI, the risk factors associated with DM made treatment more complicated. In patients with FUUTCI and under the premise of active treatments, DM was not a risk factor for urosepsis, septic shock, use of vasoactive drugs, and infection of multi-drug resistant bacteria. Compared to patients with ureteral calculi, DM was an independent risk factor for febrile urinary tract infection in patients with kidney calculi.
发热性上尿路结石合并感染（FUUTCI）患者易发生或已发生严重感染。本研究旨在评估FUUTCI患者中与糖尿病（DM）相关的潜在危险因素。
回顾性研究2018年9月至2023年12月我院收治的FUUTCI患者。将患者分为糖尿病组（n = 52）和非糖尿病组（n = 148），比较两组患者的人口统计学、病因、入院时感染指标、治疗及结局的差异。然后对性别、结石部位、尿源性脓毒症的发生、感染性休克、血管活性药物的使用、细菌多重耐药、真菌培养阳性以及两种或更多种抗生素的使用进行回归分析。
与非糖尿病患者（148例，74.0%）相比，糖尿病患者（52例，26.0%）的心血管和脑血管疾病患病率更高（P = 0.031），使用两种或更多种抗生素的比例更高（P = 0.029），酵母培养阳性率更高（P = 0.037），入院时或急诊时降钙素原值更高（P = 0.022）。结石部位存在显著差异（P = 0.039）。回归分析表明，与输尿管结石患者相比，DM是肾结石患者发热性尿路感染的独立危险因素（P = 0.032）。
在FUUTCI患者中，与DM相关的危险因素使治疗更加复杂。在FUUTCI患者中，在积极治疗的前提下，DM不是尿源性脓毒症、感染性休克、血管活性药物使用及多重耐药菌感染的危险因素。与输尿管结石患者相比，DM是肾结石患者发热性尿路感染的独立危险因素。
