{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T20:39:55Z","timestamp":1791059995148,"version":"4.1.0"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic granulomatous infection of renal parenchyma. XGP is often associated with long-term urinary tract obstruction due to stones and infection. We aimed to analyze the clinical, laboratory, and microbial culture profiles from bladder and kidney urine of patients who were diagnosed with XGP. Databases of patients with histopathological diagnosis of XGP from 10 centers across 5 countries were retrospectively reviewed between 2018 and 2022. Patients with incomplete medical records were excluded. A total of 365 patients were included. There were 228 (62.5%) women. The mean age was 45 \u00b1 14.4 years. The most common comorbidity was chronic kidney disease (71%). Multiple stones were present in 34.5% of cases. Bladder urine culture results were positive in 53.2% of cases. Kidney urine culture was positive in 81.9% of patients. Sepsis and septic shock were present in 13.4% and 6.6% of patients, respectively. Three deaths were reported. Escherichia coli was the most common isolated pathogen in both urine (28.4%) and kidney cultures (42.4%), followed by Proteus mirabilis in bladder urine cultures (6.3%) and Klebsiella pneumoniae (7.6%) in kidney cultures. Extended-spectrum beta-lactamases producing bacteria were reported in 6% of the bladder urine cultures. On multivariable analysis, urosepsis, recurrent urinary tract infections, increased creatinine, and disease extension to perirenal and pararenal space were independent factors associated with positive bladder urine cultures. On multivariable analysis, only the presence of anemia was significantly more frequent in patients with positive kidney cultures. Our results can help urologists counsel XGP patients undergoing nephrectomy.<\/jats:p>","DOI":"10.3390\/pathogens12050695","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T03:22:19Z","timestamp":1683775339000},"page":"695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Presentation, Microbiological Characteristics, and Their Implications for Perioperative Outcomes in Xanthogranulomatous Pyelonephritis: Perspectives from a Real-World Multicenter Practice"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-7141","authenticated-orcid":false,"given":"Vineet","family":"Gauhar","sequence":"first","affiliation":[{"name":"Department of Minimally Invasive Urology, Ng Teng Fong General Hospital, Singapore 609606, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9606-6183","authenticated-orcid":false,"given":"Jos\u00e9 Iv\u00e1n","family":"Robles-Torres","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez,\u201d Monterrey 64460, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Langer","family":"Wroclawski","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Israelita Albert Einstein, BP\u2014A Benefic\u00eancia Portuguesa de S\u00e3o Paulo, Sao Paulo 05562-900, SP, Brazil"},{"name":"Faculdade de Medicina do ABC, Santo Andr\u00e9 09060-870, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hegel","family":"Trujillo-Santamar\u00eda","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Covadonga, C\u00f3rdoba 94560, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-2342","authenticated-orcid":false,"given":"Jeremy Yuen Chun","family":"Teoh","sequence":"additional","affiliation":[{"name":"S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiloren","family":"Tanidir","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Marmara University, Istanbul 34854, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Urology, Mahatma Gandhi Mission\u2019s Medical College and Hospital, Aurangabad 431003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6255-0193","authenticated-orcid":false,"given":"Nariman","family":"Gadzhiev","sequence":"additional","affiliation":[{"name":"Urology Department, Saint Petersburg State University Hospital, 199034 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Ragoori","sequence":"additional","affiliation":[{"name":"Department Urology, Asian Institute of Nephrology and Urology, Hyderabad 500082, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department Urology, Christian Medical College, Vellore 632004, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Ganpule","sequence":"additional","affiliation":[{"name":"Department of Urology, Muljibhai Patel Urological Hospital, Ahemadabad 387001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9055-0238","authenticated-orcid":false,"given":"Pankaj Nandkishore","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Department of Urology, Fortis Hospital Mulund, Mumbai 400078, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Roberto","family":"Garc\u00eda-Chairez","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez,\u201d Monterrey 64460, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana Valeria","family":"Enrriquez-\u00c1vila","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez,\u201d Monterrey 64460, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Francisco","family":"Monz\u00f3n-Falconi","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucat\u00e1n, M\u00e9rdida 97133, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Esqueda-Mendoza","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucat\u00e1n, M\u00e9rdida 97133, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Flores-Tapia","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Regional de Alta Especialidad de la Penisula de Yucat\u00e1n, M\u00e9rdida 97133, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo Octaviano","family":"Duarte-Santos","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Municipal Dr. Moys\u00e9s Deutsch (M\u2019Boi Mirim), Sao Paulo 04849-030, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mudasir","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department Urology, Christian Medical College, Vellore 632004, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkat","family":"Arjunrao Gite","sequence":"additional","affiliation":[{"name":"Department Urology, Grant Medical College & Sir JJ hospital, Mumbai 400008, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mriganka","family":"Mani Sinha","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-6478","authenticated-orcid":false,"given":"Bhaskar K.","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7354-9190","authenticated-orcid":false,"given":"Daniele","family":"Castellani","sequence":"additional","affiliation":[{"name":"Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1126\/science.288.5464.287","article-title":"Infectious History","volume":"288","author":"Lederberg","year":"2000","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.2174\/138161209788168119","article-title":"The Gut Microbiota as a Target for Improved Surgical Outcome and Improved Patient Care","volume":"15","author":"Kinross","year":"2009","journal-title":"Curr. 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