• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.346-353
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• 2002

Purpose : Penicillin- and multidrug-resistant S. pneumoniae poses a serious threat to clinicians because the rate of resistance of S. pneumoniae to penicillin in Korea has surged up to the world's highest level. This study was performed to assess the carriage rate, serogroups and antimicrobial susceptibility of S. pneumoniae isolated from oropharynx in children. Methods : From March to July 1998, 209 children under 5 years of age were recruited from five day care centers. The carriage rate for pneumococci was obtained. Antimicrobial susceptibilities were determined with the E-test and agar dilution methods. Serogrouping was performed on 48 of the pneumococcal isolates by the Quellung reaction. Results : The carriage rate of S. pneumoniae was 30.1%. Antimicrobial susceptibility profiles were available for 59 of the isolates. Sixty-six percent of isolates were not susceptible to penicillin, and multidrug-resistance was observed in 76.3% of the isolates. A high proportion of the penicillin-resistant strains showed associated resistance to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and oxacillin. The most prevalent oropharyngeal serogroups were 19, 6, 3, 23, and 29. Resistance of the pneumococcal isolates to penicillin was different according to the serogroups. All of the strains of serogroup 19, 23, and 29 was resistant to penicillin but 87.5% of serogroup 3 strains were susceptible to penicillin. Conclusion : The resistance rate of S. pneumoniae isolated from oropharynx in children was very high to penicillin and other antimicrobial agents. For the reduction of the drug-resistant rate of S. pneumoniae, clinicians should be required to be more judicious in their use of antimicrobial agents.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.24-30
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• 1997

Purpose: To evaluate the diagnositc value of the absolute and relative renal uptake rates on $^{99m}Tc-DMSA$ renal scan of children with febrile UTI. Method: The absolute and relative renal uptake rates of $^{99m}Tc-DMSA$ were checked in 68 children with febrile urinary tract infection (35 with unilateral focal defect; 13 with bilateral focal defect; and 20 with diffuse bilateral defect) and 49 children with afebrile UTI and normal $^{99m}Tc-DMSA$ renal scan as control. Results: The renal absolute uptake rate in the control group were $21.8{\pm}3.9%(right),\;22.2{\pm}3.9%(left),\;and\;44.2{\pm}7.8%(total)$. The absolute uptake rate gradually increased until the age 12 months and then was stationary. In febrile UTI with unilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, both relative and absolute uptake rates were similarly diagnostic ($41.2{\pm}9.7%,\;16.5{\pm}5.4%$ vs $50.0{\pm}2.6%,\;22.0{\pm}3.9%$, p<0.01). In acute pyelonephritis with bilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly more diagnostic than the relative uptake rate[$17.3{\pm}5.3%$ (right), $17.4{\pm}5.3%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$, (left)% p<0.01]. In febrile UTI with bilateral diffuse defects on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly diagnostic than the relative uptake rate [$18.1{\pm}3.9%\;(right),\;18.4{\pm}3.8%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$(left), p<0.01]. Conclusion: In the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was more useful than the relative uptake rate to evaluate bilateral acute pyelonephritis.