urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2022-10-4-70-78urovest-626Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESФакторы риска реинфекции у пациентов после дренирования верхних мочевых путей по поводу обструктивного пиелонефритаRisk factors for re-infection in patients after drainage of the upper urinary tract due to obstructive pyelonephritishttps://orcid.org/0000-0002-5755-5950МамаевИ. Э.MamaevI. E.

Мамаев Ибрагим Энверович — кандидат медицинских наук, доцент кафедры урологии и андрологии РНИМУ им. Н.И. Пирогова Минздрава России; заведующий урологическим отделением ГКБ имени В.М. Буянова ДЗМ.

117321, Москва, ул. Островитянова, д. 1; 115516, Москва, ул. Бакинская, д. 26

Ibragim E. Mamaev — M.D., Cand.Sc.(Med), Assoc. Prof. (Docent), Dept. of Urology and An-drology, Pirogov Russian National Research Medical University (Pirogov Medical University); Head, Urology Division, Buyanov Moscow City Clinical Hospital — Moscow Healthcare Department.

1 Ostrovityanova St., Moscow, 117997; 26 Bakinskaya St., Moscow, 115560

dr.mamaev@mail.ruhttps://orcid.org/0000-0002-0167-4344АлекберовЭ. М.AlekberovE. M.

Алекберов Эмиль Мушфигович — клинический ординатор кафедры урологии и андрологии РНИМУ им. Н.И. Пирогова; врач урологического отделения ГКБ имени В.М. Буянова ДЗМ.

117321, Москва, ул. Островитянова, д. 1; 115516, Москва, ул. Бакинская, д. 26

Emil M. Alekberov — M.D., Resident, Dept. of Urology and Andrology, Pirogov Russian National Research Medical University (Pirogov Medical University); Urologist, Urology Division, Buyanov Moscow City Clinical Hospital — Moscow Healthcare Department.

1 Ostrovityanova St., Moscow, 117997; 26 Bakinskaya St., Moscow, 115560

alekberov.e.m@yandex.ruhttps://orcid.org/0000-0002-1989-3254ГлининК. И.GlininK. I.

Глинин Кирилл Игоревич — ассистент кафедры урологии и андрологии РНИМУ им. Н.И. Пирогова; врач урологического отделения ГКБ имени В.М. Буянова ДЗМ.

117321, Москва, ул. Островитянова, д. 1; 115516, Москва, ул. Бакинская, д. 26

Kirill I. Glinin — M.D., Assist.Prof., Dept. of Urology and Andrology, Pirogov Russian National Research Medical University (Pirogov Medical University); Urologist, Urology Division, Buyanov Moscow City Clinical Hospital — Moscow Healthcare Department.

1 Ostrovityanova St., Moscow, 117997; 26 Bakinskaya St., Moscow, 115560

glinin.doc@gmail.comhttps://orcid.org/0000-0001-9130-148XСайпулаевГ. Ш.SaypulaevG. Sh.

Сайпулаев Гаджимурад Шамильевич — врач урологического отделения ГКБ имени В.М. Буянова ДЗМ.

115516, Москва, ул. Бакинская, д. 26

Gadzhimurad Sh. Saipulaev — M.D., Urologist, Urology Division, Buyanov Moscow City Clinical Hospital — Moscow Healthcare Department.

26 Bakinskaya St., Moscow, 115560

dr.saipulaev@mail.ruhttps://orcid.org/0000-0003-3764-6131КотовС. В.KotovS. V.

Котов Сергей Владиславович — доктор медицинских наук, профессор, заведующий кафедрой урологии и андрологии РНИМУ им. Н.И. Пирогова Минздрава России.

117321, Москва, ул. Островитянова, д. 1

Sergey V. Kotov — M.D., Dr.Sc.(Med), Full Prof., Head, Dept. of Urology and Andrology, Pirogov Russian National Research Medical University (Pirogov Medical University).

1 Ostrovityanova St., Moscow, 117997

urokotov@mail.ruРоссийский национальный исследовательский медицинский университет им Н.И. Пирогова Минздрава России; Городская Клиническая Больница имени В.М. Буянова Департамента здравоохранения МосквыРоссияPirogov Russian National Research Medical University (Pirogov Medical University); Buyanov Moscow City Clinical Hospital — Moscow Healthcare DepartmentRussian FederationГородская Клиническая Больница имени В.М. Буянова Департамента здравоохранения МосквыРоссияBuyanov Moscow City Clinical Hospital — Moscow Healthcare DepartmentRussian FederationРоссийский национальный исследовательский медицинский университет им Н.И. Пирогова Минздрава РоссииРоссияPirogov Russian National Research Medical University (Pirogov Medical University)Russian Federation2022261220221047078Copyright © Мамаев И.Э., Алекберов Э.М., Глинин К.И., Сайпулаев Г.Ш., Котов С.В., 20232023Мамаев И.Э., Алекберов Э.М., Глинин К.И., Сайпулаев Г.Ш., Котов С.В.Mamaev I.E., Alekberov E.M., Glinin K.I., Saypulaev G.S., Kotov S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/626Введение

Введение. Реинфекция после дренирования обструктивного пиелонефрита усугубляет послеоперационное течение заболевания и отодвигает срок возможного хирургического вмешательства, направленного на устранение причины обструкции.

Цель исследования

Цель исследования. Определить долю пациентов, демонстрирующих развитие клинически значимой реинфекции после дренирования верхних мочевых путей по поводу обструктивного пиелонефрита, исследовать связь сроков дренирования с развитием инфекционно-воспалительных осложнений, а также оценить факторы риска развития реинфекции.

Материалы и методы

Материалы и методы. Проведён анализ данных 1022 пациентов, находившихся на стационарном лечении в период с января 2019 года по декабрь 2021 года, которым проведено дренирование верхних мочевых путей по поводу обструктивного пиелонефрита. Раздельно оценены данные у пациентов после нефростомии и стентирования. Проведён ретроспективный анализ времени и частоты развития реинфекции, а также влияние сахарного диабета на повторное развитие пиелонефрита.

Результаты

Результаты. Клиническая картина реинфекции за время дренирования развилась у 16 (4,8%) пациентов с нефростомой и 45 (6,5%) пациентов со стентом. В группе нефростомии реинфекция отмечена в течение первых 2-х недель с момента дренирования у четырёх (25%) пациентов, на 3 – 4 неделе — у 11 (69%). В группе стентирования количество больных, имевших инфекционное осложнение в первые две недели составляло 15 (33%), а в последующие две недели достигало 22 (49%). Доля пациентов с сахарным диабетом оказалась выше среди тех, у кого пиелонефрит развился повторно.

Заключение

Заключение. Доля пациентов, госпитализированных с клиникой реинфекции после дренирования верхних мочевых путей, составила 6%. Отмечена тенденция к нарастанию числа госпитализаций с рецидивом пиелонефрита на фоне дренажа при сроке дренирования, превышающем 2 недели. Продемонстрирована статистически значимая разница в риске развития реинфекции между 1 – 2 и 3 – 4 неделями дренирования (p < 0,05).

Introduction

Introduction. Reinfection after drainage of obstructive pyelonephritis exacerbates the postoperative course of the disease and delays the possible surgical intervention aimed at eliminating the cause of obstruction.

Objectives

Objectives. To determine the percentage of re-infection in patients drained with double-J stent or nephrostomy catheter for obstructive pyelonephritis. To assess the relationship between the timing of drainage removal and development of re-infection. To establish risk factors for the development of re-infection.

Materials and methods

Materials and methods. Medical records from 1022 patients who were treated from January 2019 to December 2021 and underwent drainage for obstructive pyelonephritis. The data in patients after nephrostomy and stenting were evaluated separately. A retrospective analysis of the time and frequency of the development of re-infection, as well as the effect of diabetes mellitus on pyelonephritis relapse, was carried out.

Results

Results. Re-infection during drainage developed in 16 (4.8%) patients with a nephrostomy and 45 (6.5%) patients with a stent. Among those who had re-infection in the nephrostomy-group, 4 (25.0%) patients noted it within two weeks from the moment of drainage, and 11 (69.0%) at three-four weeks. In the stent-group, the number of patients who had a complication during the first two weeks was 15 (33.0%), and it was 22 (49.0%) during the next two weeks, The proportion of patients with diabetes mellitus was higher among those who developed pyelonephritis again.

Conclusion

Conclusion. The percentage of patients hospitalized with clinical re-infection after drainage of the upper urinary tract was 6.0%. There was an increase in the number of hospitalizations with recurrent pyelonephritis in cases where the drainage period lasted more than two weeks (p < 0.05).

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The authors declare that there are no conflicts of interest present.