Anatomical abnormality of the urinary tract including:
obstruction (i.e. stone), ileal conduit/urinary diversion, and instrumentation/foreign body (i.e. stent, nephrostomy tube)
Immunosuppressed patients (this includes poorly controlled diabetes).
Upper tract infection complicated by abscess, papillary necrosis, or emphysematous pyelonephritis.
Consider need for urologic intervention to obtain source control or relieve obstruction
Consider Infectious Disease consultation to individualize therapy and duration
Organisms are similar to other UTI (Enterobacteriaceae, Enterococci), but E. Coli represents less and there is an increased proportion of Pseudomonas, drug resistant organisms, Staphylococci, and Candida.