말기암환자에서의 경피적신루설치술 후 발생된 요로감염균주의 특징
The Characteristics of Uropathogen after Percutaneous Nephrostomy in Patients with Palliative Care
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Purpose: Obstructive uropathy due to malignant diseases is not only associated with urinary tract infection but also renal failure. Palliative decompression using either percutaneous nephrostomy tubes or internal stents improves renal function but is associated with significant morbidity and affecting quality of life. We investigated the characteristics of uropathogens related percutaneous nephrostomy with patients with terminal care. Materials and Methods: A retrospective chart review was conducted of patients who had a nephrostomy tube inserted for malignant ureteric obstruction between January 2007 and July 2012. We analyzed parameters including previous cancer, creatine before nephrostomy procedure, visual analogue scale,creatinine before procedure, and urinary tract infection after nephrostomy tube insertion including urine culture and blood culture. Results: There were 143 patients with percutaneous nephrostomy in our hospital. Of these patients, 42 had percutaneous nephrostomy for ureteral obstruction with malignancy. Tumors were of urological origin in 50%of patients. Of these patients, 17 had positive urine culture results. Enterococcus faecalis was the most common bacteria grown. Conclusions: We considered that UTI was not a rare complication of palliative decompression of malignant ureteral obstruction, and resistance for antibiotics increases, especially ciprofloxacin. Identification of risk factors for UTI might further improve the safety of percutaneous nephrostomy.
Abstract
Purpose: Obstructive uropathy due to malignant diseases is not only associated with urinary tract infection but also renal failure. Palliative decompression using either percutaneous nephrostomy tubes or internal stents improves renal function but is associated with significant morbidity and affecting quality of life. We investigated the characteristics of uropathogens related percutaneous nephrostomy with patients with terminal care. Materials and Methods: A retrospective chart review was conducted of patients who had a nephrostomy tube inserted for malignant ureteric obstruction between January 2007 and July 2012. We analyzed parameters including previous cancer, creatine before nephrostomy procedure, visual analogue scale,creatinine before procedure, and urinary tract infection after nephrostomy tube insertion including urine culture and blood culture. Results: There were 143 patients with percutaneous nephrostomy in our hospital. Of these patients, 42 had percutaneous nephrostomy for ureteral obstruction with malignancy. Tumors were of urological origin in 50%of patients. Of these patients, 17 had positive urine culture results. Enterococcus faecalis was the most common bacteria grown. Conclusions: We considered that UTI was not a rare complication of palliative decompression of malignant ureteral obstruction, and resistance for antibiotics increases, especially ciprofloxacin. Identification of risk factors for UTI might further improve the safety of percutaneous nephrostomy.
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