• Pediatric Infection and Vaccine
• /
• 제17권2호
• /
• pp.67-73
• /
• 2010

목적:소아 UTI에서 non-E. coli UTI 의 빈도를 확인하고 원인균주별(E. coli vs. non-E. coli) 임상양상과 항생제 내성률을 비교하고자 하였다. 방 법: 2008년 9월부터 2009년 8월까지 UTI 입원 환아 중에서 원인균주가 배양 증명된 환아들을 대상으로 하였다. 인구학적 특징, 임상양상, 검사소견, 원인균주와 항생제 내성률을 전향적으로 조사하였다. 결과:전체 84명 중 E. coli UTI 은 63명(75.0%)이었고 non-E. coli UTI은 21명(25.0%)이었다. 성별 연령군에 따라서 non-E. coli의 분포는 차이를 보였다 : 6개월 미만 남아군, 10.5%; 6개월 이상 남아군, 50.0%; 6개월 미만 여아군, 43.7%; 6개월 이상 여아군, 25.0% (P =0.014). E. coli UTI군에 비해, non-E. coli UTI 군에는 입원 전 항생제를 치료받은 환아의 비율이 높았고(P=0.017), 혈뇨가 동반된 환아의 비율은 낮았다(P=0.014). E. coli 보다 non-E. coli는 cefazolin과 cefotaxime, imipenem, TMP/SMX, tetracycline에 대해 높은 내성률을 보였다(P<0.05). 결론:소아 UTI 치료과정에서, 증가 추세의 non-E. coli UTI 빈도와 성별 연령군별 원인균주의 차이, E. coli 보다 높은 non-E. coli의 항생제 내성률은 고려되어야 할 사항이다.

• Biomolecules & Therapeutics
• /
• 제4권3호
• /
• pp.265-270
• /
• 1996

The purpose of this study was to determine pharmacokinetic parameters and tissue distribution patters of urinary trypsin inhibitor(UTI) in Sprague-Dawley rats. $Na^{125}$I was conjugated to UTI to make $^{125}I-UTI$ and the concentrations were determined by $\gamma$-counter. With the aid of nonlinear least-square regression analysis for i.v bolus injection of 1,000 unit UTI including $^{125}I-UTI$, the temporal concentration curves were best fitted by 2-compartment open model. The distribution phase half-life was 0.39$\pm$0.02 hours whereas the elimination half-life was 12.99$\pm$1.05 hours in male rats. The volume of distribution and total body clearance in male rats were 0.28$\pm$0.01 1/kg and 83.16$\pm$1.15 ml/kg/h, respectively. We could not find any difference of pharmacokinetic parameters of UTI between male and female rats. UTI were distributed widely in rat organs. In both male and female rats, the kidney was the highest distributed organ. Amount of UTI in 24 hour cumulative urine in male rats was 36.22$\pm$8.74% and that in 48 hours was 43.32$\pm$10.55%. Excretion via feces was very scanty, with the 24 hours cumulative amount being only 2.76$\pm$0.97%. This data suggest the main excretion route of UTI is urine.

• 고신대학교 의과대학 학술지
• /
• 제33권2호
• /
• pp.159-170
• /
• 2018

Objectives: The purpose of this study was to compare antibiotic resistance patterns between first urinary tract infection (UTI) and recurrent UTI groups and to obtain information regarding empirical antibiotic selection for treating recurrent UTI. Methods: We retrospectively reviewed 148 children treated for UTIs from January 2009 to June 2016. The patients were divided into two groups: first UTI (N = 148) and recurrent UTI (17 patients and 20 episodes). Results: In both groups, Escherichia coli was the most frequent causative organism, accounting for 89.9% and 75.0% in the first and recurrent UTI groups, respectively. When E. coli or Klebsiella pneumoniae was the causative organism, extended-spectrum ${\beta}-lactamase$ (ESBL)-producing organisms were more frequent in the recurrent UTI group (17.6%) than in the first UTI group (14.0%); however, this difference was not statistically significant (P = 0.684). Cefotaxime was the most frequently used first-line empirical antibiotic in both groups. In the first UTI and recurrent UTI groups, 7.4% and 15.0% of patients were treated with intravenous antibiotics as definitive therapy, respectively (P = 0.250). Fifteen out of 17 patients having a second UTI had different causative organisms or antibiotic susceptibility patterns compared to their previous episode. Conclusions: Escherichia coli was the most frequent causative organism in the recurrent UTI group. There were no differences in the proportion of ESBL-producing organisms between the first UTI and recurrent UTI groups. Therefore, when a UTI recurs in children, the antibiotics effective on the most common causative organism might be administered as empirical antibiotics.

• Journal of Yeungnam Medical Science
• /
• 제33권2호
• /
• pp.105-111
• /
• 2016

Background: Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. Methods: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. Results: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum ${\beta}2$-microglobulin levels than the non-UTI group ($1.56{\pm}0.43mg/L$ vs. $1.2{\pm}0.43mg/L$, p<0.028). Conclusion: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum ${\beta}2$-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

• Clinical and Experimental Pediatrics
• /
• 제64권7호
• /
• pp.347-354
• /
• 2021

Background: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a valuable biomarker of urinary tract infection (UTI) in children. Purpose: This study aimed to compare the diagnostic accuracy of urinary NGAL (uNGAL) with those of serum C-reactive protein (CRP) and white blood cell (WBC) count for predicting UTI and acute pyelonephritis (APN) in febrile children. Methods: The medical charts of children undergoing uNGAL measurements between November 2017 and August 2019 were retrospectively reviewed. Patients with a suspected or diagnosed UTIs were included. The diagnostic accuracies of uNGAL, serum CRP, and WBC count for detecting UTI and APN were investigated. Independent predictors of UTI and APN were investigated using multivariable logistic regression analyses. Results: A total of 321 children were enrolled in this study. The uNGAL levels were higher in the UTI group (n=157) than in the non-UTI group (n=164) (P<0.05). Among children with a UTI, uNGAL levels were higher in the APN group (n=70) than, the non-APN group (n=87) (P<0.05). In the multivariate analysis, uNGAL was independently associated with UTI and APN (both P<0.05). Serum CRP and WBC count were not correlated with the presence of UTI and APN. Receiver operating curve analyses showed that the uNGAL level had the highest area under the curve (AUC) for predicting UTI and APN, respectively (AUC, uNGAL vs. CRP vs. WBC count, 0.860 vs. 0.608 vs. 0.669 for UTI; 0.780 vs. 0.680 vs. 0.639 for APN, all P<0.05, respectively). The predictive values and likelihood ratios of uNGAL were superior to those of serum CRP and WBC count for detecting UTI and APN at each cutoff level. Conclusion: UNGAL may be more useful than serum CRP and WBC count for identifying and assessing UTI in febrile children.

• Journal of Yeungnam Medical Science
• /
• 제38권3호
• /
• pp.225-230
• /
• 2021

Background: We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS). Methods: From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS. Results: Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%). Conclusion: This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

• Childhood Kidney Diseases
• /
• 제22권2호
• /
• pp.58-63
• /
• 2018

Purpose: We observed an association between obesity and UTI in infants and pediatric patients, which we aimed to validate in this study. Method: The medical records of 740 patients (${\leq}24$ months old) hospitalized with fever were retrospectively analyzed. The patients were subdivided into 2 groups, namely, the UTI and control (non UTI) groups. We analyzed the patient's height, weight. Obesity was defined as weight-for-length ${\geq}95^{th}$ percentile, and the association between obesity and UTI was evaluated. Results: Out of 740 patients, 253 and 487 patients were in the UTI group and the control group, respectively. A comparative analysis, based on 3 age groups (0-5 months, 6-11 months, and 12-24 months) showed higher proportion of obesity in the UTI group (26.4%) than in the control group (13.0%) in the 0-5months group. After adjusting for age and gender in the 0-5month group, the obesity group was 3.76 times likely to have an UTI (95% CI 1.419-9.98). Conclusion: Obesity and UTI show strong association, especially in infants aged 0-5 months. Febrile obese infant patients (${\leq}5$ months old) visiting medical centers should be advised urine tests for potential UTI.

• Clinical and Experimental Pediatrics
• /
• 제61권1호
• /
• pp.17-23
• /
• 2018

Purpose: To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months. Methods: A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment of congenital hydronephrosis or renal pelvis dilatation, without a UTI, formed the control group. The correlation between the presence and grade of VR and UTI was evaluated. Results: The prevalence rate of VR was higher in the UTI (42.9%) than control (13.7%) group (P<0.05), with a higher VR severity grade in the UTI (mean, 0.64) than control (mean, 0.18) group (P<0.05). On subanalysis with age-matching (UTI group: n=126, age, $5.28{\pm}2.13months$; control group: n=22, age, $4.79{\pm}2.40months$; P=0.33), both VR prevalence (43.65% vs. 18.18%, P<0.05) and grade (0.65 vs. 0.22, P<0.05) remained higher in the UTI than control group. Presence and higher grade of VR were associated with UTI recurrence (P<0.05). VR was correlated to urosepsis (P<0.05). The renal defect rate of patients with VR (VR [+]/VUR [+]) was not different from that of patients without VR (74% vs. 52%, P=0.143) in the VUR group; however, it was higher than that of VR (+)/VUR (-) patients (74% vs. 32%, P=0.001). If a child with VR (+)/VUR (+) is exposed to a UTI, the risk of renal defect increases. Conclusion: Occurrence of VR is associated with UTI recurrence and urosepsis in pediatric female patients.

• Biomolecules & Therapeutics
• /
• 제5권3호
• /
• pp.223-227
• /
• 1997

The protective effect of human urinary trypsin inhibitor(UTI) on acute hemorrhagic shock in beagle dog was studied. Hemorrhagic shock was experimentally induced in thoracotomized beagle dogs by removing blood and maintaining low arterial blood pressure for 30 min, and then blood removed was entirely transfused back into the dogs within one hour. When the blood was transfused, UTI was administered together to check the potential protective effect of UTI on hemorrhagic shock. The arterial blood pressure recovery was accelerated slightly by UTI treatment. Blood pH and $P_{a co2}$ returned to normal level in shorter time in the UTI treatment group. These data suggest that UTI may have protective effects on experimentally induced hemorrhagic shock.

• Clinical and Experimental Pediatrics
• /
• 제61권1호
• /
• pp.24-29
• /
• 2018

Purpose: The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and ${\beta}-2$ microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever. Methods: A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission. The sensitivity, specificity, accuracy, and area under the curve (AUC) of uNGAL and uB2MG for use in diagnosing UTI were assessed. Results: Among 422 patients, 102 (24.2%) were diagnosed with UTI. Levels of uNGAL were higher in the UTI group than in the non-UTI group (366.6 ng/mL vs. 26.9 ng/mL, P<0.001). Levels of uB2MG were not different between the 2 groups. Multivariate analysis revealed that uNGAL was an independent predictive factor for UTI (P=0.033). The sensitivity, specificity, and accuracy were 90.2%, 92.5%, and 91.9% for uNGAL, and 48.0%, 43.8%, and 44.8% for uB2MG, respectively. AUC of uNGAL was 0.942 and that of uB2MG was 0.407. Conclusion: Accuracy of uNGAL in the diagnosis of UTI is high in febrile infants aged <3 months. uNGAL can help in the early diagnosis and treatment of UTI in infants.