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Article

Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice

by
Vineet Gauhar
1,
José Iván Robles-Torres
2,
Marcelo Langer Wroclawski
3,4,
Hegel Trujillo-Santamaría
5,
Jeremy Yuen Chun Teoh
6,
Yiloren Tanidir
7,
Abhay Mahajan
8,
Nariman Gadzhiev
9,
Deepak Ragoori
10,
Santosh Kumar
11,
Arvind Ganpule
12,
Pankaj Nandkishore Maheshwari
13,
Luis Roberto García-Chairez
2,
Joana Valeria Enrriquez-Ávila
2,
Juan Francisco Monzón-Falconi
14,
Antonio Esqueda-Mendoza
14,
Juan Pablo Flores-Tapia
14,
Hugo Octaviano Duarte-Santos
15,
Mudasir Farooq
11,
Venkat Arjunrao Gite
16,
Mriganka Mani Sinha
17,
Bhaskar K. Somani
17 and
Daniele Castellani
18,*add Show full author list remove Hide full author list
1
Department of Minimally Invasive Urology, Ng Teng Fong General Hospital, Singapore 609606, Singapore
2
Urology Department, Hospital Universitario “Dr. José Eleuterio González,” Monterrey 64460, Mexico
3
Department of Urology, Hospital Israelita Albert Einstein, BP—A Beneficência Portuguesa de São Paulo, Sao Paulo 05562-900, SP, Brazil
4
Faculdade de Medicina do ABC, Santo André 09060-870, SP, Brazil
5
Department of Urology, Hospital Covadonga, Córdoba 94560, Mexico
6
S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China
7
Department of Urology, School of Medicine, Marmara University, Istanbul 34854, Turkey
8
Department of Urology, Mahatma Gandhi Mission’s Medical College and Hospital, Aurangabad 431003, India
9
Urology Department, Saint Petersburg State University Hospital, 199034 Saint Petersburg, Russia
10
Department Urology, Asian Institute of Nephrology and Urology, Hyderabad 500082, India
11
Department Urology, Christian Medical College, Vellore 632004, India
12
Department of Urology, Muljibhai Patel Urological Hospital, Ahemadabad 387001, India
13
Department of Urology, Fortis Hospital Mulund, Mumbai 400078, India
14
Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucatán, Mérdida 97133, Mexico
15
Department of Urology, Hospital Municipal Dr. Moysés Deutsch (M’Boi Mirim), Sao Paulo 04849-030, SP, Brazil
16
Department Urology, Grant Medical College & Sir JJ hospital, Mumbai 400008, India
17
Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
18
Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Università Politecnica delle Marche, 60126 Ancona, Italy
 
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*
Author to whom correspondence should be addressed.
Pathogens 2023, 12(5), 695; https://doi.org/10.3390/pathogens12050695
Submission received: 12 April 2023 / Revised: 3 May 2023 / Accepted: 9 May 2023 / Published: 10 May 2023
(This article belongs to the Special Issue Pathogenesis, Prophylaxis and Treatment of Uropathogenic Infections)
Review Reports Versions Notes

Abstract

Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic granulomatous infection of renal parenchyma. XGP is often associated with long-term urinary tract obstruction due to stones and infection. We aimed to analyze the clinical, laboratory, and microbial culture profiles from bladder and kidney urine of patients who were diagnosed with XGP. Databases of patients with histopathological diagnosis of XGP from 10 centers across 5 countries were retrospectively reviewed between 2018 and 2022. Patients with incomplete medical records were excluded. A total of 365 patients were included. There were 228 (62.5%) women. The mean age was 45 ± 14.4 years. The most common comorbidity was chronic kidney disease (71%). Multiple stones were present in 34.5% of cases. Bladder urine culture results were positive in 53.2% of cases. Kidney urine culture was positive in 81.9% of patients. Sepsis and septic shock were present in 13.4% and 6.6% of patients, respectively. Three deaths were reported. Escherichia coli was the most common isolated pathogen in both urine (28.4%) and kidney cultures (42.4%), followed by Proteus mirabilis in bladder urine cultures (6.3%) and Klebsiella pneumoniae (7.6%) in kidney cultures. Extended-spectrum beta-lactamases producing bacteria were reported in 6% of the bladder urine cultures. On multivariable analysis, urosepsis, recurrent urinary tract infections, increased creatinine, and disease extension to perirenal and pararenal space were independent factors associated with positive bladder urine cultures. On multivariable analysis, only the presence of anemia was significantly more frequent in patients with positive kidney cultures. Our results can help urologists counsel XGP patients undergoing nephrectomy.
Keywords: xanthogranulomatous pyelonephritis; urine culture; microbiology; urinary pathogens; prognosis xanthogranulomatous pyelonephritis; urine culture; microbiology; urinary pathogens; prognosis

Share and Cite

MDPI and ACS Style

Gauhar, V.; Robles-Torres, J.I.; Wroclawski, M.L.; Trujillo-Santamaría, H.; Teoh, J.Y.C.; Tanidir, Y.; Mahajan, A.; Gadzhiev, N.; Ragoori, D.; Kumar, S.; et al. Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice. Pathogens 2023, 12, 695. https://doi.org/10.3390/pathogens12050695

AMA Style

Gauhar V, Robles-Torres JI, Wroclawski ML, Trujillo-Santamaría H, Teoh JYC, Tanidir Y, Mahajan A, Gadzhiev N, Ragoori D, Kumar S, et al. Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice. Pathogens. 2023; 12(5):695. https://doi.org/10.3390/pathogens12050695

Chicago/Turabian Style

Gauhar, Vineet, José Iván Robles-Torres, Marcelo Langer Wroclawski, Hegel Trujillo-Santamaría, Jeremy Yuen Chun Teoh, Yiloren Tanidir, Abhay Mahajan, Nariman Gadzhiev, Deepak Ragoori, Santosh Kumar, and et al. 2023. "Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice" Pathogens 12, no. 5: 695. https://doi.org/10.3390/pathogens12050695

APA Style

Gauhar, V., Robles-Torres, J. I., Wroclawski, M. L., Trujillo-Santamaría, H., Teoh, J. Y. C., Tanidir, Y., Mahajan, A., Gadzhiev, N., Ragoori, D., Kumar, S., Ganpule, A., Maheshwari, P. N., García-Chairez, L. R., Enrriquez-Ávila, J. V., Monzón-Falconi, J. F., Esqueda-Mendoza, A., Flores-Tapia, J. P., Duarte-Santos, H. O., Farooq, M., ... Castellani, D. (2023). Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice. Pathogens, 12(5), 695. https://doi.org/10.3390/pathogens12050695

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