Abstract

Pakistan
Objective: To see the pattern and prevalence of infection in obstructed kidney.
Methodology: This was a prospective study of 50 patients, 25 with completely obstructed kidney in which PCN was done to compare with other group of 25 patients with partially obstructed kidney in which ureteral catheterization was done to compare the incidence of infection. The object of breaking population into two group was because in completely obstructed group patients were febrile with completely obstructed kidney and in second group patients were afebrile and had partial obstruction. In completed obstructed kidneys, ureter was not visualized due to stone or PUJO but in partially obstructed kidney, ureter was visualized on IVU distal to the obstruction. Urine specimens were collected in sterile bottle for culture and sensitivity.
Results: 57% and 42% of the patients acquired renal infection in completely and partially obstructed kidney, respectively. E. coli was the most prevalent organism in 66.67% of patients with completely obstructed kidney followed by E. coli plus Klebsiella in 17.67%. While in patients with partially obstructed kidney, E. coli was prevalent organism in 77.78% followed by Pseudomonas and Proteus in 22.22%.
Conclusion: Patients with obstructed kidney should be managed as soon as possible to decrease the morbidity of UTI and other complication of renal insufficiency. PCN is effective measure in case of completely obstructive kidney and when patients febrile. In partially obstructive kidney, ureteral sampling before URS is better to see the prevalence of organism in affected unit.

Key words: Obstructed kidney, UTI, PCN.