• Childhood Kidney Diseases
• /
• 제19권2호
• /
• pp.118-124
• /
• 2015

Purpose: The symptoms and signs of urinary tract infection (UTI) in early infancy are non-specific. Prompt diagnosis of UTI is important, as untreated UTI results in renal damage. Especially, febrile UTI in young infants coexist with other serious bacterial infections. The purpose this study was to propose modified Rochester criteria to differentiate viral infection from urinary tract infection. Methods: We carried out a retrospective investigation of 168 infants less than three months old with a tympanic temperature $>38^{\circ}C$ who were admitted to Chung-Ang University Hospital between 2011 and 2014. We compared the symptoms, physical examination results, and laboratory data between viral infection and UTI groups. A modified Rochester criterion was composed of statistically significant factors. Results: A total of 76 and 92 infants with UTI and a viral infection, respectively, were included. Statistically significant differences in gender, previous admission history, neutrophil ratio, and urine WBC count were found between the two study groups. Using a cut off value of 3 points, the sensitivity and specificity of the modified Rochester criteria were 71.28% and 78.57%, respectively. Conclusion: The modified Rochester criteria may give an outline for identifying young infants with UTI.

• Childhood Kidney Diseases
• /
• 제24권1호
• /
• pp.27-35
• /
• 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.

• Childhood Kidney Diseases
• /
• 제27권2호
• /
• pp.111-116
• /
• 2023

Purpose: This article was to investigate the association between urinary tract infections (UTIs) and high weight status in infancy. Methods: We conducted a nationwide matched cohort study from January 2018 to December 2020 using data from the Korean National Health Insurance System and the Korean National Health Screening Program for Infants and Children. We analyzed the association between UTI diagnosis codes and high weight status (which was defined as being in the 90th percentile or higher of weight-for-age). Results: We found that 22.8% of infants with UTIs exhibited high weight status, compared to 20.0% of non-UTI infants (P<0.001). Per our multivariable analyses, the adjusted odds ratio for high weight status was 1.09 (95% confidence interval, 1.06-1.13). Conclusions: UTI in the first 12 months of life was associated with a weight-for-age percentile of ≥90. Our findings corroborate those of previous single-center studies and emphasize the importance of careful monitoring for this at-risk group.

• Childhood Kidney Diseases
• /
• 제21권2호
• /
• pp.101-106
• /
• 2017

Purpose: The aim of this study was to analyze the incidence and microbiological characteristics of urinary tract infection in infants aged younger three months and to compare with other infection with positive urine culture. Methods: We retrospectively reviewed the medical records of 425 infants with a tympanic temperature >$37.6^{\circ}C$, aged younger than three months, who were admitted to Cheil General Hospital in Seoul, Korea, from January 2013 to December 2016. Demographic and clinical features, laboratory findings, respiratory virus PCR and the pathogens of a urine culture were analyzed. Results: A total of 88 infants (63 males, 25 females) had urinary pathogens detected in the urine culture test. The incidence of UTI in febrile infants aged younger 3 months was 11%. The most common pathogen which causes UTI was E. coli as same as in previous studies. They were divided into a UTI group (n=48) and a non-UTI group (n=40). In comparison of both group, leukocytosis, C-reactive protein level, Absolute neutrophil count level, peak temperature is statistically significant. In both group, there were co-infections with viral pathogens in some cases, and the odd ratio of non-UTI group with viral infection was 3.28. Conclusion: The study determined the incidence and pathogen of UTI in febrile infants, aged younger three months. E. coli was responsible for the majority UTI. There were some viral co-infections in febrile infants with bacteriuria and incidence was higher in non-UTI group. WBC count, ANC count and CRP level were the differentiating factors of UTI from non-UTI group.

• 한국산학기술학회논문지
• /
• 제18권3호
• /
• pp.85-93
• /
• 2017

요로감염은 병원 내 감염의 주요한 부분이며 최근 항생제의 남용 등으로 인해 요로감염에서의 효과적인 항생제의 선택이 제한받고 있다. 연구자들은 본 병원을 방문하여 시행한 요배양검사에서 의미있는 균이 동정된 외래 및 입원 환자의 요로감염의 주요 원인균과 항생제 감수성을 조사하여 요로감염의 치료에 도움을 주고자 하였다. 2010년 1월 1일부터 2015년 12월 31일까지 6년간 본 병원에서 시행한 요배양검사에서 의미 있는 원인균이 동정된 외래 및 입원환자를 대상으로 하였으며 균집락 단위(colony forming unit: CFU)가 $10^5/ml$이상인 환자를 대상으로 하였다. 배양된 동정균주에서 가장 흔한 원인균은 E.coli로 28.1%의 비율이었다. E.coli의 경우 남성에서는 2010년부터 2015년까지 빈도의 차이는 없었으나 여성의 경우 2014년 이후 그 빈도가 점차 감소하였다. 항생제 감수성 결과 가장 흔한 균주인 E.coli의 감수성 검사에서는 ampicillin 72.2%, TMP/SMX (trimethoprim/sulfamethoxazole) 44.9%, ciprofloxacin 41.3%의 내성율을 보였으며, cefazolin 12.4%, 2,3,4세대 cephalosporin에는 5% 이하의 낮은 내성율을 보였다. 요로감염의 원인균은 시간이 지날수록 다양해지고 빈도 또한 변화를 보인다. 따라서 TMP/SMX와 ciprofloxacin 등 기존 항생제에 대한 내성도 또한 비교적 높은 것으로 나타나 향후 요로감염에 대한 경험적인 항생제의 사용에 대해 더욱 신중한 선택을 해야 할 것으로 생각한다.

• Journal of Microbiology and Biotechnology
• /
• 제25권10호
• /
• pp.1714-1727
• /
• 2015

This work describes a new strategy for optimal design of Multiplex-PCR primer sequences. The process is based on the Particle Swarm Optimization-Simplex algorithm (Mult-PSOS). Diverging from previous solutions centered on heuristic tools, the Mult-PSOS is selfconfigured because it does not require the definition of the algorithm's initial search parameters. The successful performance of this method was validated in vitro using Multiplex-PCR assays. For this validation, seven gene sequences of the most prevalent bacteria implicated in urinary tract infections were taken as DNA targets. The in vitro tests confirmed the good performance of the Mult-PSOS, with respect to infectious disease diagnosis, in the rapid and efficient selection of the optimal oligonucleotide sequences for Multiplex-PCRs. The predicted sequences allowed the adequate amplification of all amplicons in a single step (with the correct amount of DNA template and primers), reducing significantly the need for trial and error experiments. In addition, owing to its independence from the initial selection of the heuristic constants, the Mult-PSOS can be employed by non-expert users in computational techniques or in primer design problems.

• Pediatric Infection and Vaccine
• /
• 제5권1호
• /
• pp.136-138
• /
• 1998

Shigella spp. cause classic bacillary dysentery that rarely result in extraintestinal complications. Urinary tract infections(UTIs) due to Shigella spp. are rare, and Shigella sonnei UTIs are extremely rare. We report a case of symptomatic UTI due to S. sonnei. A 9-year-old female presented with a history of fever, abdominal pain, loose form diarrhea, vomiting, and dysuria for 1 day. S. sonnei was identified from urine culture and stool culture result was no Salmonella and Shigella isolated. She was treated with gentamicin and cefuroxime intravenously for 5 days, which suscessfully controlled clinical features of infections.

• 임상간호연구
• /
• 제22권2호
• /
• pp.132-141
• /
• 2016

Purpose: The aims of this study were to develop and apply the urinary elimination facilitation program for stroke patients with urinary disorders and evaluate the effectiveness of the program. Methods: This study was conducted using the non-equivalent control group pre- posttest design. The participants included 23 patients in the control group and 22 in the experimental group. Data were collected from Nov. 25, 2013 to Nov. 25, 2014 in acute rehabilitation inpatient wards. For the final analysis, 35 patients' data were utilized 17 in the control group and 18 in the experimental group. The developed urinary elimination facilitation program was continued for 7 days and the program consisted of logging urination, monitoring timely voiding, assisting urinary elimination, and stimulating urination using sound. The data were analyized using the SPSS-win (version 21). Results: The number of urinary catheterization and the urinary discomfort were significantly improved in the experimental group compared to the control group. However residual urine and the occurrence of urinary tract infections were not significantly different between the experimental and control groups. Conclusion: The results of this study indicated that the urinary elimination intervention program for stroke patients with urination disorder could be useful in decreasing the number of urinary catheterization and the urinary discomfort.

• 대한간호학회지
• /
• 제19권3호
• /
• pp.249-258
• /
• 1989

The purpose of study was to confirm theory about the effectiveness of routine mental care on the reduction of catheter-associated urinary tract infection. The study was carried out at a university hospital from September 1,1987 to April 17, 1989 : 32 Patients with a foley -catheter were studied. The study compared the urinary tract infection rate of an experimental group with that of a control group and tested the antibiotic susceptibility of the isolated bacteria. The experimental group(16 patients) was given daily meatal care with 10% Betadine for periods ranging from 4 to 21 days. The control group(16 patients) was not given that care. The results obtained were as follows : 1. The urinary tract infection rate of the experimental group was 50.0 %, and that of the control group 43.8%. There was no significant difference between the groups. 2. Organisms isolated in the control group were bacteria 100%, and in the experimental group bacteria 50% and fungus 50%. The most common organisms of the 15 strains isolated in the total group were Staphylococcus coagulase negative (3 patients), and E-coli (3 patients). 3. Most of bacteria isolated in this study were sensitive to Norfloxacillin, but resistant to Ampicillin, Chloramphenicol, Kanamycin, Tetracycline, and Erythromycin. Hence the importance of controling catheter-associated urinary tract infections. Findings suggest the need to search for other sources of infection, further experimentation controling various sources of urinary tract infection and larger group of subjects.

• 간호행정학회지
• /
• 제20권1호
• /
• pp.128-143
• /
• 2014

Purpose: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. Methods: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. Results: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. Conclusion: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.