• Childhood Kidney Diseases
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• v.5 no.2
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• pp.176-181
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• 2001

Purpose : Urinary tract infection is a common problem in children. To evaluate for reflux most authorities recommend a voiding cystourethrogram 3 to 6 weeks after the first urinary tract infection. But during the 3 to 6 weeks interval, patients may fail to show up for the scheduled VCUG and thus risk for loss of follow up. We analyzed patient's records to evaluate whether the timing of VCUG after UTI influenced the prevalence or severity of VUR. Methods : We retrospectively reviewed 213 children diagnosed with UTI from March 1997 to December 2000. These children were divided into 2 groups according to whether they had VCUG scheduled to be performed either within 1 weeks after the diagnosis of UTI (Group A) or later than 1 week after the diagnosis(Group B). We compared tile presence and severity of reflux in the 2 groups. Results : Reflux was present in $19\%$ of the patients studied within 1 week after UTI and in $18\%$ of those studied after 1 week. This difference was not statistically significant. Whereas $100\%$ of the scheduled VCUGs in the Group A were performed, only $48\%$ of those scheduled in the Group B were performed. This difference is statistically significant. Conclusion : Because there was no significant difference between the presence or severity of reflux and timing of VCUG after UTI, we suggest that a hospitalized patient with UTI should have VCUG performed before discharge. (J. Korean Sor Pediatr Nephrol 2001 ;5 : 176-81)

• Childhood Kidney Diseases
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• v.20 no.2
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• pp.69-73
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• 2016

Purpose: The aim of this study was to compare the clinical and laboratory features of infants with roseola infantum due to human herpesvirus 6 (HHV6) infection and those with urinary tract infection (UTI). Methods: We retrospectively reviewed the medical records of children who were hospitalized at Cheil General Hospital and Women's Health Care Center, College of Medicine, Dankook University, and diagnosed as having HHV6 infection or UTI. Results: Among the infants admitted between September 2014 and May 2016, 92 (male, 45 and female, 47) were included in the study and divided into a HHV6 infection group (n=50) and a UTI group (n=42). The relative risk of UTI compared with that of HHV6 infection increased with pyuria (P<0.001), increased with leukocytosis (mean white blood cell [WBC] count, $15,048{\pm}5,756/mm^3$ vs $87,916{\pm}54,056/mm^3$; P<0.001), increased with C-reactive protein (CRP) level ($4.89{\pm}4.85 mg/dL$ vs $1.04{\pm}1.76mg/dL$; P<0.001), and younger age ($6.3{\pm}3.2months$ vs $18.3{\pm}12.6months$; P<0.001). The relative risk of HHV6 infection compared with that of UTI increased with fever duration ($4.3{\pm}1.7days$ vs $2.8{\pm}1.7days$; P<0.001) and decreased with platelet (PLT) count ($373{\pm}94{\times}10^3/mm^3$ vs $229{\pm}90{\times}10^3/mm^3$; P<0.001). No significant differences were found between the HHV6 groups according to the presence or absence of pyuria. Conclusion: Pyuria, age, fever duration, WBC count, CRP level, and PLT count were the differentiating factors of HHV6 infection from UTI. However, sterile pyuria can occur in children with HHV6 infection. In the presence of pyuria, CRP level and PLT count were the strong predictors of UTI compared with HHV6.

• Childhood Kidney Diseases
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• v.2 no.1
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• pp.90-94
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• 1998

Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.457-461
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• 2007

Purpose : Urinary tract infection (UTI) is a common bacterial infectious disease in childhood. Especially UTI in infant and young children is associated with urinary tract anomalies such as hydronephrosis, vesicoureteral reflux. The aim of this study was to compare the clinical and laboratory characteristics, and uroradiologic findings of UTI caused by pathogens other than E. coli with UTI caused by E. coli in infant and young children. Methods : We retrospectively reviewed medical records of 170 infants and children, who had been admitted for UTI to Il Sin Christian Hospital from January 2003 to December 2005. All patients were divided into two groups; E. coli and non-E. coli UTI, and they were compared for demographic data, clinical data (degree and duration of fever, time to defervescence, and length of hospital stay), underlying urinary tract anomalies (by history and ultrasonography), recurrent infection (by history and past medical records), and laboratory data [urinalysis, white blood cells (WBC) count in peripheral blood, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum creatinine level]. Results : Of the 170 UTI patients, the number of non-E. coli UTI was 114 (67.1%) and E. coli UTI was 56 (32.9%). As compared to E. coli group, non-E. coli group was younger in age ($0.52{\pm}0.59years$ vs $0.84{\pm}1.39years$, P<0.05), had higher rates of urinary tract anomalies [n=46 (82.1%) vs n=53 (46.5%), P<0.001], higher recurrence rate, shorter time to defervescence, less peripheral blood WBC count, lower level of CRP, lower level of ESR. Conclusion : The characteristics of non-E. coli UTI compared to E. coli UTI was younger age, milder clinical symptoms and signs, higher rates of urinary tract anomalies and higher recurrence rate.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.2
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• pp.223-232
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• 2012

Purpose: The purpose of this study was to compare the effects of preventing CAUTIs through the practice of using 0.05% chlorhexidine gluconate (CHG) versus normal saline for perineal care in ICU patients. Methods: A randomized controlled trial was used, and participants were randomly allocated to either the CHG group (n=79) or normal saline group (n=81). CAUTI was diagnosed following the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of CAUTI and characte oftics of infection were evaluated. Results: In the CHG group, 8 epofodes of CAUTI were obsevend in 79 patients and 875 foley catheter e ys. Tnce ate of CAUTI was 9.14 per 1,000 foley catheter e ys. Tncre were 2 epofodes of CAUTI in the 81 patients and 837 foley catheter e ys of the normal saline group. Tnce ate of CAUTI was 2.39 per 1,000 foley catheter e ys. Tnc difference between both groups was not significant (p=.1e ConConclusevaluUsing normal saline to provide perineal care to ICU patients with a foley catheter inserted will not increase the risk for CAUTI.

• Childhood Kidney Diseases
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• v.19 no.1
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• pp.8-13
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• 2015

Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

• Childhood Kidney Diseases
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• v.24 no.1
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• pp.27-35
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• 2020

Purpose: Urinary tract infections (UTIs) are the most common and serious bacterial infections in children. Therefore, early diagnosis of vesicoureteral reflux (VUR) for treatment planning and the identification of noninvasive markers that can predict renal injury are important in patients with UTIs. We analyzed the clinical features of pediatric UTIs commonly encountered by general practitioners and reinterpreted the blood tests and imaging findings to identify the important clinical predictive markers of VUR in order to selectively perform VCUG. Methods: This retrospective study was performed among 183 children diagnosed with a UTI or acute pyelonephritis. Results: The most significant predictor of high grade and bilateral VUR identified using area under the curve analyses was hydronephrosis on kidney ultrasound images with renal cortical defects on dimercaptosuccinic acid (DMSA) kidney scan simultaneously, followed by hydronephrosis only on kidney ultrasound. Conclusion: The presence of hydronephrosis on kidney ultrasound images or cortical defects or asymmetric kidneys on the DMSA kidney scans can be predictive markers of VUR, reducing the need for VCUG. Our study can thus help minimize the exposure to radiation among patients through selective VCUG.

• Journal of Home Health Care Nursing
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• v.18 no.2
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• pp.126-132
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• 2011

Purpose: The purpose of this study was to investigate the degree of LUTS (Lower Urinary Tract Symptoms) and factors affecting LUTS in patients with prostate cancer. Methods: Fifty-four patients with prostate cancer participated and they completed a structured questionnaire at a hospital in Seoul. The LUTS level was measured by using the International prostate symptom score (1992) and the data were analyzed by Wilcoxon rank sum test and Kurskal-Wallis test. Results: Most subjects obtained a higher than moderate LUTS score. The participants who had a lower perceived health status and did not drink alcohol were more likely to had a lower LUTS score than other patients who had higher perceived health status and drink alcohol. In addition, eye diseases were significantly associated with the LUTS score. In LUTS, all the patients received higher IPSS-QOL (International prostate symptom score quality of life) and frequency, nocturia. Conclusion: For proper nursing care related to LUTS, nurses should focus on the factors identified when performing nursing assessments and should develop nursing intervention programs for symptoms management.

• Biomedical Science Letters
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• v.21 no.2
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• pp.84-91
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• 2015

To provide guidelines for the empirical treatment of urinary tract infections, we observed annual changes in the occurrence frequency and antimicrobial susceptibility of urinary isolates in a university hospital in the Chungbuk province, South Korea, over a period of 10 years (2004~2013). Escherichia coli (38.2%), Enterococcus faecalis (11.7%), Klebsiella pneumoniae (7.3%), Pseudomonas aeruginosa (4.3%), E. faecium (4.3%), and Staphylococcus aureus (4.1%) were commonly isolated urinary pathogens. The prevalence of E. coli, E. faecium and Streptococcus agalactiae were significantly higher in females (P < 0.001), whereas E. faecalis, P. aeruginosa and S. aureus were significantly more common in male patients (P < 0.001). E. coli mostly frequently showed resistance to ampicillin (67.94%), followed by trimethoprim/sulfamethoxazole (36.06%) and ciprofloxacin (26.84%). Over the studied time period, resistance rates of E. coli to ciprofloxacin significantly increased (20.44% to 33.55%). Moreover, extended-spectrum $\beta$-lactamase (ESBL) producing isolates also significantly increased in E. coli (4.2% to 18.3%) and K. pneumoniae (9.6% to 26.9%). In addition, the proportion of vancomycin-resistant Enterococcus facium (VRE) also increased (15.7% to 25.0%). In conclusion, over the last 10 years, the proportions of ciprofloxacin resistant E. coli and multidrug-resistant bacteria, such as ESBL and VRE have significantly increased. This trend must be strictly controlled and demonstrates the need for more updated guidelines for the treatment of urinary tract infections.

• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.298-305
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• 2002

These cases were performed on the bases of clinical consideration about patients who had Methicillin-Resistant Staphylococcus aureus(MRSA) infection. One patient was a 67-years-old women who had sequela of inter cranial hemorrhage & inter ventricular hemorrhage, hypertention, urinary tract infection and pneumonia. Clinical symptoms were intermittent fever, sputum, Lt. side hemiparesis and dysphagia. She was chronic, repeated infection state. It could be regarded as "unpreparedness of the spirit which animates and controls the universe; 正氣虛", the oriental term which indicates a condition of chronic disease or general weakness. According to the oriental medicine principle, oriental medicine was taken such as Wunggunza-tang(六君子湯) and the patient had taken a turn for the better. After 3 months, MRSA infection diappeared. The other patient was a 43-years-old women who had Both brain stem infarction, Lt. cerebellar infarction, hypercholesterolemia, urinary tract infection and pneumonia, Clinical symptoms were quadriplegia, dysphagia(levin tube insert state), aphasia, respiration disorder(tracheostomy cannular keep state) and sputum. She was chronic, repeated infection state. It could be regarded as "unpreparedness of spleen energy, unpreparedness of both energy and blood; 脾氣虛, 氣血兩虛", the oriental term which indicates a condition of chronic disease or immunodeficiency. According to the oriental medicine principle, oriental medicine was taken such as Bojungyggi-tang(補中益氣湯), Palmul-tang(八物湯) and the patient had taken a turn for the better. After I month, MRSA was turned into Escherichia coli.