{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:36:46Z","timestamp":1792190206340,"version":"4.4.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>Patients with febrile upper urinary tract calculi with infection (FUUTCI) are prone to develop or have developed severe infection. This research aimed to evaluate the potential risk factors associated with diabetes mellitus (DM) in patients with FUUTCI.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>From September 2018 to December 2023, patients with FUUTCI admitted to our hospital were retrospectively studied. The patients were divided into a diabetic group (n=52) and a non-diabetic group (n=148), and the differences in demographics, etiology, infection indicators on admission, treatment, and outcome between the two groups were compared. Then regression analysis was performed for gender, stone location, occurrence of urinary sepsis, septic shock, use of pressors, bacterial multiresistance, positive fungal culture, and use of two or more antibiotics.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Compared with non-diabetic patients (148 cases, 74.0%), diabetic patients (52 cases, 26.0%) had a higher prevalence of cardiovascular and cerebrovascular diseases (P=0.031), the rate of using two or more antibiotics (P=0.029), the positive rate of yeast culture (P=0.037), the procalcitonin value of admission or emergency (P=0.022). There was a significant difference in stone location (P=0.039). Regression analysis showed that DM was an independent risk factor for febrile urinary tract infection in patients with kidney stones compared to patients with ureteral stones (P=0.032).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In patients with FUUTCI, the risk factors associated with DM made treatment more complicated. In patients with FUUTCI and under the premise of active treatments, DM was not a risk factor for urosepsis, septic shock, use of vasoactive drugs, and infection of multi-drug resistant bacteria. Compared to patients with ureteral calculi, DM was an independent risk factor for febrile urinary tract infection in patients with kidney calculi.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0325724","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T17:28:18Z","timestamp":1751045298000},"page":"e0325724","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Potential risk factors associated with diabetic mellitus in patients with Febrile upper urinary tract calculi with infection"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0060-6454","authenticated-orcid":true,"given":"Meng","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoqiang","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongchao","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"pone.0325724.ref001","author":"A Skolarikos","year":"2024"},{"issue":"12","key":"pone.0325724.ref002","first-page":"430","article-title":"Diabetes mellitus is associated with increased risk of positive qSOFA score but not with increased ICU admission in patients undergoing ureteral stent placement for ureteral stone and suspected infection","volume":"16","author":"J Lee","year":"2022","journal-title":"Can Urol Assoc J"},{"key":"pone.0325724.ref003","doi-asserted-by":"crossref","first-page":"3588297","DOI":"10.1155\/2022\/3588297","article-title":"Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes","volume":"2022","author":"S Paudel","year":"2022","journal-title":"J Diabetes Res"},{"key":"pone.0325724.ref004","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/j.jiac.2018.08.002","article-title":"Comparison between non-septic and septic cases in stone-related obstructive acute pyelonephritis and risk factors for septic shock: A multi-center retrospective study","volume":"24","author":"F Yamamichi","year":"2018","journal-title":"J Infect Chemother"},{"issue":"8","key":"pone.0325724.ref005","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/j.jiac.2021.05.012","article-title":"Complicated urinary tract infections with diabetes mellitus","volume":"27","author":"J Kamei","year":"2021","journal-title":"J Infect Chemother"},{"issue":"1","key":"pone.0325724.ref006","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-032094","article-title":"Does chronic hyperglycaemia increase the risk of kidney stone disease? results from a systematic review and meta-analysis","volume":"10","author":"R Geraghty","year":"2020","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0325724.ref007","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.urology.2011.07.1431","article-title":"Increased risk of urinary tract calculi among patients with diabetes mellitus--a population-based cohort study","volume":"79","author":"H-S Chen","year":"2012","journal-title":"Urology"},{"issue":"9","key":"pone.0325724.ref008","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11934-022-01103-y","article-title":"Association of Kidney Stones and Recurrent UTIs: the Chicken and Egg Situation. 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