• Childhood Kidney Diseases
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• v.21 no.2
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• pp.101-106
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• 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.

• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.286-291
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• 2002

Urinary tract infection(UTI) is one of the common complications in stroke patients. As it has negative effect on the recovery of stroke, it should be cured out immediately. But antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting. so there have been several reports about treating urinary tract infection with Traditional Korean Medication. We treated a 54-year-old male patient with cerebral hemorrhage, who had had neurogenic bladder after stroke and had been urinated by intermittent catheterization. About 10 days later, he could void by himself without catheter, but showing the symptoms of UTI; Voiding pain, hematuria and yellowish pus. The pus culture grew Staphylococcus spp., which was resistant to most of antibiotics except vancomycin and teicoplanin. Based on accompanying symptoms of intermittent dizziness, headache, insomnia, nocturnal sweating, weak pulse, red tongue and urinary problem, we differentiated him as the deficiency of Yin of the Kidney[腎陰虛] and treated with Gagamyookmijihwang-tang (Jia-Jian-Liu-Wei-De- Huang-Tang), which improved his urinary symptoms and other general conditions without any side effect. In next follow-up culture, there was no pathogen. We conclude that Traditional Korean Medicine based on differentiation is useful in the treatment of urinary tract infection.

• 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.

• Journal of Microbiology and Biotechnology
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• v.25 no.10
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• pp.1714-1727
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• 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.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.143-147
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• 2015

Purpose: Burkholderia cepacia is an aerobic, glucose-non-fermenting, gram-negative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. Methods: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. Results: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28.6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. Conclusion: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.136-142
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• 2015

Purpose: Although the American Academy of Pediatrics provides clinical guidelines for urinary tract infection (UTI) infants, guidelines are not appropriate for neonates and infants less than 2 months of age due to insufficient data. The aim of this study was to evaluate the characteristics of neonates and young infants less than 2 months old (group 1) with UTI compared to older infants from 2 to 12 months old (group 2). Methods: We reviewed UTI patients aged 0 to 12 months admitted to the pediatric department in the last 5 years. Clinical characteristics such as age, sex, fever duration, recurrence, progression to acute pyelonephritis (APN), malformations like hydronephrosis and vesicoureteral reflux (VUR), and laboratory results were compared between group 1 and group 2. Results: 615 patients were included in this study. Group 1 had 94 cases and group 2 had 521 cases. Escherichia coli was the most commonly isolated pathogen in urine cultures. Fever duration was shorter in group 1 (vs.) 2 ($1.91{\pm}1.43$ days vs. $3.42{\pm}2.40$ days, P<0.05). As compared to group 2, group 1 had a higher proportion of patients with antenatal hydronephrosis and hydronephrosis found after admission (10.6% vs. 3.6% and 75.5% vs. 55.9%, P<0.05). There were differences between two groups in white blood cell (WBC) count (Group 1: $13,694{\pm}5,315/{\mu}L$, Group 2: $15,271{\pm}6,130/{\mu}L$, P<0.05) and C-reactive protein (Group 1: $32.02{\pm}35.17mg/L$, Group 2: $46.51{\pm}46.63mg/L$, P<0.05). Conclusion: Compared to older infants, UTI in neonates and young infants shows milder clinical manifestations except higher rates of hydronephrosis but outcome is alike.

• Journal of Pharmacopuncture
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• v.26 no.3
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• pp.265-275
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• 2023

Objectives: The aim of this study was to evaluate the effect of fruit juices on Multi-Drug Resistant (MDR) bacterial pathogens involved in Urinary Tract Infections (UTIs) and Sexually Transmitted Infections (STIs) among tribal women in the district Anuppur, Madhya Pradesh, India. Methods: Fresh juices of lemon (Citrus limon), amla/Indian gooseberry (Phyllanthus emblica), pineapple (Ananas comosus), mosambi/sweet lime (Citrus limetta), orange (Citrus sinensis), kiwi (Actinidia deliciosa), and pomegranate (Punica granatum) fruits were evaluated for in vitro antibacterial activity against bacterial pathogens involved in UITs and STIs among tribal women. Physico-chemical analysis of fresh fruits was also carried out by measuring the pH, moisture, protein, fat, crude fibre, carbohydrate, and ascorbic acid content. Results: Lemon and amla juice showed better antibacterial activity against the pathogens as compared to other juices. MIC results fruit juices against UTIs and STIs pathogens vary depending on the specific pathogen and juice chemical constituents. The physico-chemical analysis showed that the moisture content was highest in mosambi (90%), followed by orange (87%). Ascorbic acid content was found highest in amla (540 mg/100 g), followed by kiwi (90.3 mg/100 g). Pomegranate showed highest concentration of carbohydrate (15.28 g/100 g), fat (1.28 g/100 g), and protein (1.65 g/100 g). Lemon juice had lowest pH of 2.20, followed by amla 2.67. Conclusion: The lemon juice showed highest antibacterial activity against MDR bacterial pathogens involved in UTIs and STIs among tribal women in district Anuppur, Madhya Pradesh, India. The low pH of lemon may be responsible for its high antibacterial activity as compared to other juices.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.29-35
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• 2015

Purpose: The purpose of this study was to investigate the clinical characteristics and outcome of febrile urinary tract infections (UTIs) caused by community-acquired extended-spectrum ${\beta}$-lactamase (CA-ESBL)-producing and -nonproducing bacteria. Methods: We analyzed febrile UTIs in children hospitalized at Gachon University Gil Medical Center from January 2011 to December 2013 through retrospective data collection from their medical records. Results: Among pathogens causing 374 episodes of UTIs, the proportion of ESBL-producing bacteria was 13.1% (49/374). The proportion of ESBL-producing Escherichia coli and Klebsiella spp. was 13.6% (48/354) and 5.0% (1/20), respectively. There was no significant difference between the CA-ESBL and CA non-ESBL groups in duration of fever ($4.2{\pm}2.7$ vs. $3.7{\pm}2.1$ days, P=0.10) and bacterial eradication rate with empirical antibiotics (100% vs. 100%). The risk of cortical defects on renal scan significantly depended on existence of vesicoureteral reflux rather than ESBL production of pathogen. Conclusions: There was no significant difference between the CA-ESBL and CA non-ESBL groups in renal cortical defects and clinical outcome. Careful choice of antibiotics is important for treatment of community-acquired UTI in children.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.194-200
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• 2015

Purpose: Urinary tract infection (UTI) is a common bacterial infection in children and Escherichia coli is a predominant pathogen. The purpose of this study is to evaluate phylogenetic groups and virulence factors of E. coli causing UTI in children in Korea. Methods: From October 2010 to April 2013, urinary E. coli strains were isolated from the 33 pediatric patients of UTI. Multiplex polymerase chain reactions were performed to evaluate the phylogenetic groups and 5 virulence factor genes (fimH, sfa, papA, hylA, and cnf1) of E. coli. Distribution of molecular characteristics of E. coli was analyzed by clinical diagnosis and accompanying vesicoureteral reflux (VUR). Results: Most (84.8%) uropathogenic E. coli were belonged to phylogenetics group B2 and the others (15.2%) were belonged to group D. The virulence factors were distributed as: fimH (100%), sfa (100%), hylA (63.6%), cnfI (63.6%), and papA (36.4%). According to clinical diagnosis, phylogenetic distribution of E. coli strain was 92.3% of B2 and 7.7% of D in acute pyelonephritis and 57.1% of B2 and 42.9% of D in cystitis. Distribution of virulence factors was similar in both groups. In patients with acute pyelonephritis, phylogenetic distribution was similar in VUR and non-VUR group, but proportion of papA genes were lower in VUR group than that of non-VUR group (43.8% vs. 20.0%, P=0.399). Conclusions: This study provides current epidemiologic molecular data of E. coli causing pediatric UTI in Korea and will be a fundamental for understanding the pathogenesis of pediatric UTI.

• International Journal of Advanced Culture Technology
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• v.12 no.1
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• pp.190-201
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• 2024

This study examined the effect of the distance Infection Control Education Program (ICEP), developed based on the ADDIE model, on infection control knowledge, attitude, and performance among care workers in long-term care facilities nationwide. The program, developed based on the ADDIE model, was applied to 173 care workers directly responsible for nursing care of elderly residents in lomg-term care facilities. The distance ICEP for care workers was conducted through the website and lasted 30 minutes for each of the eight topics. To determine the effectiveness of the education, infection control knowledge, attitude, performance, and satisfaction were surveyed before and four weeks after the program. Differences in infection control knowledge, attitude, and performance before and after the distance ICEP were assessed by a t-test. A significant difference was observed in knowledge and infection control performance after the distance ICEP was administered to care workers. In the sub-domains of infection control performance, overall understanding of infection, regular infection control education, infection control by special pathogen (multidrug-resistant bacteria, tuberculosis, tick-borne infectious diseases), and detailed infection control education by infection site (pressure ulcers and urinary tract infections) were significantly improved. Infection control knowledge and performance improved through the distance ICEP applied to care workers. Satisfaction also displayed high scores on most items and indicated that it was helpful for infection control in facilities, confirming the effectiveness of infection control education. Based on the survey of care workers nationwide, the infection education program can be effectively used for care workers in the future.