BACTEREMIA IN YOUNG URBAN WOMEN ADMITTED WITH PYELONEPHRITIS

The objective of this study was to determine the rate of bacteremia in young women admitted to the hospital with presumed pyelonephritis and compare it with other published rates. The study design was a retrosp ective, structured chart review and a review of published reports of b acteremic py elonephritis. An urban county teaching hospital provided the setting for the study. The patients were nonpregnant women (n = 98 ) 44 years of age or younger who were without bladder dysfunction and who had not been admitted to an intensive care unit. Further criteria for participation included discharge with the diagnosis of acute pyelo nephritis. Blood cultures were ordered for 69 women; the results of 64 were noted in the chart. Twenty-three women (35.9% of those cultured; 23.4% of all patients) were diagnosed with bacteremia. In patients fo r whom blood culture results were obtained, trends developed between t hose patients with bacteremia and those with complicated pyelonephriti s, defined as a known or newly discovered genitourinary ab. normality or a risk factor (P = 0.044), those who were black (P = .044), those w ith higher pulses on admission (P =.050), those with more white blood cells per high-powered field after urinalysis (P = 0.007), and those w hose fever lasted longer (P = 0.033). Blood culture results were posit ive in two patients whose urine cultures were negative. This comparati vely high bacteremia rate supports routine ordering of blood cultures for urban women suspected of having pyelonephritis.