菌血症を呈した尿路感染症の治療経過の検討

Abstract

Although bacteremia is often concomitant with severe urinary tract infection (UTI), the treatment outcome has not been well studied. The aim of this study was to verify treatment outcome in patients with bacteremia caused by UTI. We also assessed the efficacy of sequential oral antibiotics. According to a retrospective chart review of patients treated in the Sapporo Medical University Hospital from 2013 to 2016, bacteremia caused by UTI was observed in 59 patients. Intravenous antibiotics were sequentially converted to oral agents in 48 patients. Of them, 14 patients had recurrence after initial treatment. There was no significant difference in recurrence rate between events with and without conversion to oral antibiotics. Use of a steroid or immunosuppressant was significantly associated with recurrence of bacteremia caused by UTI. In patients with recurrence of UTI, treatment period was significantly long. In patients with bacteremia caused by UTI, antibiotic agents can be converted to a culture-directed oral antibiotic safely. However, we should notice the high risk of recurrence in patients treated with a steroid or immunosuppressant.