Urogenital Tract Infection

Original Articles

Clinical Characteristics and Risk Factors of Fournier Gangrene: A 15-Years Multicenter Retrospective Study in Korea: Seung-Kwon Choi, Sin Woo Lee, Hyung-Lae Lee, Jeong Woo Lee, Jung Sik Huh, Yeonjoo Kim, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2025;20(3):159-166. Published online December 31, 2025; DOI: https://doi.org/10.14777/uti.2550036018

Abstract PDF: Purpose
Fournier gangrene (FG) is a rare but life-threatening necrotizing infection requiring prompt recognition and intervention. This multicenter study aimed to investigate the clinical characteristics, treatment outcomes including mortality, and risk factors associated with death among patients with FG over the past 15 years in Korea. Materials and Methods: We retrospectively reviewed 84 patients diagnosed with FG between 2008 and 2022 across 7 hospitals. Demographics, comorbidities, laboratory findings, and clinical outcomes were analyzed. Mortality-related risk factors were assessed using univariate and multivariate logistic regression analysis.
Results
The mean age was 58.1±15.9 years, and 95.2% of patients were male. Diabetes mellitus (42.9%) and hypertension (36.9%) were the most prevalent comorbidities. Sepsis developed in 38.1% of patients, and the overall mortality rate was 14.3%. In univariate analysis, age ≥70 years, low body mass index, diabetes mellitus, low hemoglobin, low hematocrit, high respiratory rate, and Fournier gangrene severity index (FGSI) ≥9 were significantly associated with mortality. After data correction and multivariate adjustment, diabetes mellitus (odds ratio [OR], 39.61; 95% confidence interval [CI], 2.39–656.32; p=0.010) and respiratory rate (OR, 1.44; 95% CI, 1.09–1.91; p=0.011) were identified as independent predictors of mortality. FGSI≥9 demonstrated borderline association with mortality (p=0.08), indicating its potential clinical relevance.
Conclusions
In this multicenter Korean cohort, the mortality rate of FG remained substantial at 14.3%. Diabetes mellitus and elevated respiratory rate were independent predictors of mortality, while FGSI≥9 demonstrated a borderline yet clinically meaningful association, suggesting its role as a useful severity indicator in early risk stratification.

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Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study: Seung-Kwon Choi, Jeong Woo Lee, Seung Il Jung, Eu Chang Hwang, Joongwon Choi, Woong Bin Kim, Jung Sik Huh, Jin Bong Choi, Yeonjoo Kim, Jae Min Chung, Ju-Hyun Shin, Jae Hung Jung, Hong Chung, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2025;20(1):34-41. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550006003

Purpose
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN. Materials and Methods: Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Characteristics and Treatment Trends for Emphysematous Pyelonephritis in Korea: A 10-Year Multicenter Retrospective Study: Seung-Kwon Choi, Koo Han Yoo, Jeong Woo Lee, Seung Il Jung, Eu Chang Hwang, Joongwon Choi, Woong Bin Kim, Jung Sik Huh, Jin Bong Choi, Yeonjoo Kim, Jae Min Chung, Ju-Hyun Shin, Jae Hung Jung, Hong Chung, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2021;16(2):49-54. Published online August 31, 2021; DOI: https://doi.org/10.14777/uti.2021.16.2.49

Abstract PDF PubReader ePub: Purpose: This study examined the characteristics, current treatment trends, and outcomes of patients with emphysematous pyelonephritis (EPN) in Korea.
Materials andMethods: Two hundred and seventeen patients diagnosed with EPN were evaluated using abdominal computed tomography in 2011-2021 at 15 institutes in Korea. The patients’ demographic and clinical characteristics, treatment modalities, and treatment outcomes were analyzed. The total study period was divided arbitrarily into groups A (2011-2014), B (2015-2017), and C (2018-2021) to analyze the trends in the EPN treatment.
Results: The mean age of the patients was 65.1 years; there were more female patients (74.2%) than male patients. The overall mortality rate was 10.6%. Ninety-five (43.8%), 98 (45.2%), and 24 (11.0%) patients were treated with medical, minimally invasive, and surgical management, respectively; the corresponding mortality rates were 13.7%, 6.1%, and 16.7%. There was no significant change in the proportion of patients treated with medical management over time (group A=46.5%, group B=47.0%, and group C=38.8%). The proportion of patients treated with minimally invasive management gradually increased over time (group A=35.2%; group B=43.9%; group C=55.0%), while those who underwent surgical management decreased gradually over time (group A=18.3%, group B=9.1%, and group C=6.3%). No differences in mortality rates were observed between the groups.
Conclusions: EPN with medical and minimally invasive management had a relatively high treatment success rate, which increased gradually, while surgical management decreased gradually over time in Korea. The mortality rate was relatively lower than that reported in studies published before the 2010s.

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