Introduction: This study examined the risk factors for initial treatment failure in renal or retroperitoneal abscess as a multicenter study. Materials and Methods: This retrospective analysis investigated consecutive patients with renal or retroperitoneal abscess who were hospitalized in Japan. The outcomes of these patients were classified into “cured” and “failure or recurrence.” The potential clinical risk factors examined were abscess size, diabetes mellitus, major organ failure, laboratory data, fever, drainage, and causative organisms, for instance. Results: Of the 74 patients, 40 (54.1%) were diagnosed with renal abscess and 34 (45.9%) with retroperitoneal abscess, 51 (68.9%) were cured by initial treatments, and 23 (31.1%) underwent failure or relapse; 33 (44.6%) were men and 41 (55.4%) were women. In detail, 36 patients were cured by conservative therapy only. Our multivariate analysis data showed that renal failure was the only significant factor for initial treatment failure (p = 0.0281). Conclusions: Our multivariate analysis showed that renal failure was a significant risk factor for initial treatment failure or recurrence.

Keywords:
Renal or retroperitoneal abscess, Risk factor, Initial treatment failure, Multicenter study
1.
Lee SH, Jung HJ, Mah SY, Chung BH: Renal abscesses measuring 5 cm or less: outcome of medical treatment without therapeutic drainage. Yonsei Med J 2010;51:569-573.
2.
Todd JK: Staphylococcal infections. Pediatr Rev 2005;26:444-450.
3.
Coelho RF, Schneider-Monteiro ED, Mesquita JL, Mazzucchi E, Marmo Lucon A, Srougi M: Renal and perinephric abscesses: analysis of 65 consecutive cases. World J Surg 2007;31:431-436.
4.
Kawashima A, Sandler CM, Goldman SM: Imaging in acute renal infection. BJU Int 2000;86(suppl 1):70-79.
5.
Stojadinović M, Mićić S, Milovanović D: Ultrasonographic and computed tomography findings in renal suppurations: performance indicators and risks for diagnostic failure. Urol Int 2008;80:389-397.
6.
Meng MV, Mario LA, McAninch JW: Current treatment and outcomes of perinephric abscesses. J Urol 2002;168(4 pt 1):1337-1340.
7.
Jaik NP, Sajuitha K, Mathew M, Sekar U, Kuruvilla S, Abraham G, Shroff S: Renal abscess. J Assoc Physicians India 2006;54:241-243.
8.
Lee BE, Seol HY, Kim TK, Seong EY, Song SH, Lee DW, Lee SB, Kwak IS: Recent clinical overview of renal and perirenal abscesses in 56 consecutive cases. Korean J Intern Med 2008;23:140-148.
9.
Iseki K: Chronic kidney disease in Japan. Intern Med 2008;47:681-689.
10.
Huang SH, Lo WO, Lin CM, Hsieh TS, Wang SF, Tsai SW, Chen KC: Retroperitoneal abscess: 7-year experience of 29 cases in a tertiary care center in Taiwan. Urol Sci 2015;26:218-221.
11.
Shigemura K, Tanaka K, Osawa K, Arakawa S, Miyake H, Fujisawa M: Clinical factors associated with shock in bacteremic UTI. Int Urol Nephrol 2013;45:653-657.
12.
Liu XQ, Wang CC, Liu YB, Liu K: Renal and perinephric abscesses in West China Hospital: 10-year retrospective-descriptive study. World J Nephrol 2016;5:108-114.
13.
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptebility Testing: Nineteenth Informational Supplement M100-S19. Wayne, PA: CLSI, 2009.
14.
Shu T, Green JM, Orihuela E: Renal and perirenal abscesses in patients with otherwise anatomically normal urinary tracts. J Urol 2004;172:148-150.
15.
Grabe M (Chair), Bartoletti R, Bjerklund Johansen TE, Cai T (Guidelines Associate), Çek M, Köves B (Guidelines Associate), Naber KG, Pickard RS, Tenke P, Wagenlehner F, Wullt B: 3D.4 Disease Management; in Guidelines on Urological Infections. European Association of Urology, 2015 pp 24-25.
16.
Stapleton A: Urinary tract infections in patients with diabetes. Am J Med 2002;113(suppl 1A):80S-84S.
17.
Capitán Manjón C, Tejido Sánchez A, Piedra Lara JD, Martínez Silva V, Cruceyra Betriu G, Rosino Sánchez A, García Peñalver C, Leiva Galvis O: Retroperitoneal abscesses - analysis of a series of 66 cases. Scand J Urol Nephrol 2003;37:139-144.
18.
Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K: Japanese Society of UTI Cooperative Study Group. Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol 2007;14:890-909.
19.
Tsukagoshi D, Dinkovski B, Dasan S, Jethwa J: Perinephric abscess secondary to a staghorn calculus presenting as a subcutaneous abscess. CJEM 2006;8:285-288.
20.
Kurts C, Panzer U, Anders HJ, Rees AJ: The immune system and kidney disease: basic concepts and clinical implications. Nat Rev Immunol 2013;13:738-753.
21.
Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, Tranaeus A, Stenvinkel P, Lindholm B: Aspects of immune dysfunction in end-stage renal disease. Clin J Am Soc Nephrol 2008;3:1526-1533.
22.
Russo G, Lichtner M, Carnevalini M, Mascellino MT, Mengoni F, Oliva A, Miccoli GA, Iannetta M, Trinchieri V, Massetti AP, Mastroianni CM, Vullo V: Primary retroperitoneal abscesses due to Rhodococcus equi in a patient with severe nephrotic syndrome: successful antibiotic treatment with linezolid and tigecycline. Int J Infect Dis 2010;14:e533-e535.
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2017
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