Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution
Background: Pyometra is defined as an accumulation of purulent material in the uterine cavity. It is caused by natural drainage impairment within the cervix and occurs predominantly in elderly women. In this study, we aimed to investigate the clinical characteristics and recurrent risk of pyometra....
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2023-06-01
|
| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/50/6/10.31083/j.ceog5006130 |
| _version_ | 1797789241106759680 |
|---|---|
| author | Yung-Taek Ouh Da Ye Oh Heejoo Hong Boram Lee Chorong Kim Darae Lee Yoon Hyeon Hu Se Jin Lee Tae Gyu Ahn Sung Hun Na Jong Yun Hwang Hyang Ah Lee |
| author_facet | Yung-Taek Ouh Da Ye Oh Heejoo Hong Boram Lee Chorong Kim Darae Lee Yoon Hyeon Hu Se Jin Lee Tae Gyu Ahn Sung Hun Na Jong Yun Hwang Hyang Ah Lee |
| author_sort | Yung-Taek Ouh |
| collection | DOAJ |
| description | Background: Pyometra is defined as an accumulation of purulent material in the uterine cavity. It is caused by natural drainage impairment within the cervix and occurs predominantly in elderly women. In this study, we aimed to investigate the clinical characteristics and recurrent risk of pyometra. Methods: Data for patients diagnosed with pyometra between 2010 and 2021 were retrospectively reviewed. Basic patient characteristics, including age, underlying disease, management, chief complaint, antibiotics, and isolated organisms, were investigated. The risk of recurrence of pyometra was assessed using multivariate logistic regression analyses. In total, 65 patients with pyometra were included in this study. Results: The mean age of the patients was 75.8 ± 16.4 years. About half of the patients had been admitted to a nursing hospital due to poor mobility, and 61.5% of the patients had an Eastern Cooperative Oncology Group performance score of 2 or higher. The most prevalent presenting symptoms were vaginal discharge (73.9%) and fever (16.9%). Forty-eight (75.0%) patients underwent drainage, and seven (10.9%) underwent hysterectomy. Escherichia coli accounted for the most cases (36.9%), followed by Klebsiella pneumoniae (20.0%). Overall, 17 patients were extended-spectrum β-lactamase positive. Recurrence after drainage occurred in 16 (24.6%) of the 65 patients, and two patients died from septic shock. The isolation of Klebsiella pneumoniae was identified as a significant risk factor for recurrence (odds ratio (OR): 4.71; 95% confidence interval (CI): 1.09–20.47; p < 0.05). Conclusions: Because pyometra often occurs in elderly patients with chronic diseases, it is important to pursue appropriate treatment and prevention of recurrence to decrease the morbidity and mortality associated with this condition. The isolated organisms should be considered as a predisposing factor for recurrent pyometra. |
| first_indexed | 2024-03-13T01:46:57Z |
| format | Article |
| id | doaj.art-cc8f3aca41964eeda83b6fb0f64b3d83 |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-03-13T01:46:57Z |
| publishDate | 2023-06-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-cc8f3aca41964eeda83b6fb0f64b3d832023-07-03T06:41:52ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-06-0150613010.31083/j.ceog5006130S0390-6663(23)02105-XClinical Characteristics of Pyometra: Eleven Years of Experience from a Single InstitutionYung-Taek Ouh0Da Ye Oh1Heejoo Hong2Boram Lee3Chorong Kim4Darae Lee5Yoon Hyeon Hu6Se Jin Lee7Tae Gyu Ahn8Sung Hun Na9Jong Yun Hwang10Hyang Ah Lee11Department of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaSchool of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kangwon National University, 24289 Gangwon-do, Republic of KoreaBackground: Pyometra is defined as an accumulation of purulent material in the uterine cavity. It is caused by natural drainage impairment within the cervix and occurs predominantly in elderly women. In this study, we aimed to investigate the clinical characteristics and recurrent risk of pyometra. Methods: Data for patients diagnosed with pyometra between 2010 and 2021 were retrospectively reviewed. Basic patient characteristics, including age, underlying disease, management, chief complaint, antibiotics, and isolated organisms, were investigated. The risk of recurrence of pyometra was assessed using multivariate logistic regression analyses. In total, 65 patients with pyometra were included in this study. Results: The mean age of the patients was 75.8 ± 16.4 years. About half of the patients had been admitted to a nursing hospital due to poor mobility, and 61.5% of the patients had an Eastern Cooperative Oncology Group performance score of 2 or higher. The most prevalent presenting symptoms were vaginal discharge (73.9%) and fever (16.9%). Forty-eight (75.0%) patients underwent drainage, and seven (10.9%) underwent hysterectomy. Escherichia coli accounted for the most cases (36.9%), followed by Klebsiella pneumoniae (20.0%). Overall, 17 patients were extended-spectrum β-lactamase positive. Recurrence after drainage occurred in 16 (24.6%) of the 65 patients, and two patients died from septic shock. The isolation of Klebsiella pneumoniae was identified as a significant risk factor for recurrence (odds ratio (OR): 4.71; 95% confidence interval (CI): 1.09–20.47; p < 0.05). Conclusions: Because pyometra often occurs in elderly patients with chronic diseases, it is important to pursue appropriate treatment and prevention of recurrence to decrease the morbidity and mortality associated with this condition. The isolated organisms should be considered as a predisposing factor for recurrent pyometra.https://www.imrpress.com/journal/CEOG/50/6/10.31083/j.ceog5006130pyometrauterine infectionklebsiella pneumoniaerecurrence |
| spellingShingle | Yung-Taek Ouh Da Ye Oh Heejoo Hong Boram Lee Chorong Kim Darae Lee Yoon Hyeon Hu Se Jin Lee Tae Gyu Ahn Sung Hun Na Jong Yun Hwang Hyang Ah Lee Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution Clinical and Experimental Obstetrics & Gynecology pyometra uterine infection klebsiella pneumoniae recurrence |
| title | Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution |
| title_full | Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution |
| title_fullStr | Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution |
| title_full_unstemmed | Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution |
| title_short | Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution |
| title_sort | clinical characteristics of pyometra eleven years of experience from a single institution |
| topic | pyometra uterine infection klebsiella pneumoniae recurrence |
| url | https://www.imrpress.com/journal/CEOG/50/6/10.31083/j.ceog5006130 |
| work_keys_str_mv | AT yungtaekouh clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT dayeoh clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT heejoohong clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT boramlee clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT chorongkim clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT daraelee clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT yoonhyeonhu clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT sejinlee clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT taegyuahn clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT sunghunna clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT jongyunhwang clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution AT hyangahlee clinicalcharacteristicsofpyometraelevenyearsofexperiencefromasingleinstitution |