A Study of Microbiological Profile in patients with Acute Pyelonephritis in a Tertiary Care Hospital, Nandyal
Authors: Pogula Nagarjuna Reddy Nagarjuna Reddy 
Published: April 2021

Background : Acute pyelonephritis is a bacterial infection that
affects the renal parenchyma that can be life-threatening and
often leads to renal scarring. It usually ascended from the lower
urinary tract, and also reach the kidney via the bloodstream.
Early diagnosis and management of acute pyelonephritis have
a better impact on patient outcomes. Acute pyelonephritis is
one of the severe conditions with high mortality and morbidity.
It represents the most severe form of urinary tract infection.
Acute pyelonephritis is the most common cause of communityonset bacteremia in elderly patients1.
Aim: To study the microbiological profile in patients with acute
pyelonephritis admitted in a tertiary care hospital.
Materials and Methods: A Hospital-based Prospective study
was conducted in the Department of Medicine, Santhiram
medical college & general hospital for a 2 year period.Universal
Sampling Technique was used for the selection of study
subjects.The study population included patients admitted with
fever, flank pain, and positive urine or blood cultures in the
department of general medicine in Santhiram medical college
and general hospital.The final sample size was 50 subjects.
Results: In the present study, 50 participants were selected as
the study population. The mean age of the study population
was 57.48 ± 11.21. The majority of participants (70%) were
distributed in a 50 to 69-year age group. Majority of
participants were females (60%) and males (40%).In the current
study among participants, in the current study, urine culture
was positive in 29 patients (58%) of the study population. In
29(58%) of the subjects who had a culture-positive infection,
the most predominant infectious agent in the present study
group was Escherichia. coli and was reported in 22 (44%) of
the study subjects. Other causative organisms include,
Klebsiella pneumonia was reported in 2(4%) subjects. Candida
albicans, Citrobacter, Enterococcus faecalis, and Pseudomonas
were isolated in 1 (2%) subject each. One subject had a dual
infection with Escherichia coli and Candida.In current study,
among the 29 culture isolates, none of them were resistant to
Cefperazone plus Sulbactum or Piperacillin plus tazobactam.
The highest proportion of resistance was reported for
Ampicillin as 82.1% of isolates were resistant. Levofloxacin
resistance was found in 67.9% of isolates. Gentamicin and
Amikacin resistance was found 17.86% and 3.6% of the isolates.
Nitrofurantoin resistance was found in 2 (7.1%) of isolates.
Conclusion: The mean age of the study population was 57.480
± 11.2072 years in the study population, and there was a slight
female preponderance in the occurrence of APN.The majority
of participants (78%) were distributed ina 50 to 69-year age
group.Diabetes, hypertension, ureteric calculus, and past
history of UTI were the common risk factors identified in the
study population.In.More than half (58%) of the study
population had a culture-positiveinfection.TheThe most
common organism isolated in the study population was E.Coli,
responsible for 44% of the cases. None of them were resistant
to Cefoperazone plus Sulbactum or Piperacillin plus
tazobactam. The other antimicrobials, which have not shown
any resistance, were Meropenem and Colistin.The highest
proportion of resistance was reported for Ampicillin in 82.1%,
followed by Levofloxacin in 67.9% of isolates. ICU admission
rate was higher in culture-positive cases (63.6%), as compared
to culture-negative cases (36.4%)None of the study subjects
had hospital mortality