• 제목/요약/키워드: urinary tract infection

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Clinical Significance of Extended-spectrum β-lactamase-producing Bacteria in First Pediatric Febrile Urinary Tract Infections and Differences between Age Groups

  • Park, Sun Yeong;Kim, Ji Hong
    • Childhood Kidney Diseases
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    • 제21권2호
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    • pp.128-135
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    • 2017
  • Purpose: Extended-spectrum ${\beta}$-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum ${\beta}$-lactamase -urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. Methods: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum ${\beta}$-lactamase-positive and extended-spectrum ${\beta}$-lactamasenegative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). Results: Extended-spectrum ${\beta}$-lactamase urinary tract infection occurred in 11 % patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extended-spectrum ${\beta}$-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum ${\beta}$-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. Conclusion: Extended-spectrum ${\beta}$-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum ${\beta}$-lactamase urinary tract infection.

소변 미생물 균주 양성인 중환자실 유치도뇨관 환자의 병원성 요로감염 발생과 관련요인 (Risk Factors for Nosocomial Urinary Tract Infection in the Intensive Care Unit with a Positive Urine Culture and Foley Catheterization)

  • 류성미;박경연
    • 대한간호학회지
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    • 제37권7호
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    • pp.1149-1158
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    • 2007
  • Purpose: The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture. Method: Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were 'age', 'place of catheter insertion', 'frequency of catheter change', and 'duration of catheterization'. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization. Conclusion: Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.

중환자실내 병원성 요로감염 실태와 전파경로: Imipenem Resistant P. aeruginosa[IRPA]의 분자역학적 특성을 중심으로 (Status of Nosocomial Urinary Tract Infections in the ICU: Molecular Epidemiology of Imipenem Resistant P. aeruginosa)

  • 유성미;전성숙;강인순;안혜경
    • 대한간호학회지
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    • 제36권7호
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    • pp.1204-1214
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    • 2006
  • Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

오령산(五苓散)으로 호전된 여성 하부 요로감염증 환자 치험 4례 (Four Cases Report of the Female Lower Urinary Tract Infection with Oryeong-san)

  • 정은혜;유정은;최경희;유동열
    • 대한한방부인과학회지
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    • 제25권4호
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    • pp.134-143
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    • 2012
  • Purpose: This paper aims to report the effects of Oryeong-san on lower urinary tract infection. Methods: Four women were admitted to Dunsan Oriental Hospital with chief complaint that was not supposed to be a symptom of urinary tract infection. During the admission, urine test showed pyuria with white blood cell and their chief complain also accompanied. We prescribed Oryeong-san three times a day, and then took follow-up 4 days later. Results: After treatment, symptoms of lower urinary tract infection were decreased and the results of urine test improved also. Conclusions: These cases indicate that Oryeong-san is effective in treatment of the lower urinary tract infection.

노인요양시설 요양보호사의 요로감염 예방행위에 대한 지식과 실천 (The Caregiver's Knowledge and Practice about Preventive Behavior for Urinary Tract Infection in Long-term Care Facilities)

  • 오영주;송영신
    • 예술인문사회 융합 멀티미디어 논문지
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    • 제9권10호
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    • pp.407-421
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    • 2019
  • 본 연구의 목적은 노인요양시설의 요양보호사를 대상으로 요로감염 예방행위와 관련된 지식과 실천 정도를 조사하여 간호사가 요양보호사에게 요로감염 예방행위의 중요성을 인지시키고 지도, 교육하는데 필요한 기초자료를 제공하고자 시도된 서술적 조사연구이다. 연구대상은 J도에 소재한 7개의 노인요양시설에서 근무하는 요양보호사 198명이였다. 자료분석을 위해 t-test, one-way ANOVA, Scheffes test로 분석을 실시하였다. 요로감염 예방행위에 대한 지식의 정답률은 79%였으며, 대상자의 일반적 및 직무관련 특성에 따른 요로감염 예방행위에 대한 실천은 근무하는 간호사의 수, 담당 노인의 수, 근무시간, 교육의 중요성과 필요성을 인지한 군, 교육을 받은 경험에서 통계적으로 유의한 차이가 나타났다. 본 연구결과를 바탕으로 요양보호사를 위한 체계적인 교육을 통한 지식함양 요구의 기초교육뿐 아니라 의료인에 의한 관리 감독 하에 지속적인 요로감염 예방행위의 실천은 노인요양시설의 기본 감염관리 체계를 완성하고 서비스의 질을 향상 시킬 수 있을 것이다.

A Case of Infantile Fungal Urinary Tract Infection

  • Cho, Wonhee;Jo, Young Min;Oh, Yun Kyo;Rim, Ji Woo;Lee, Won Uk;Choi, Kyongeun;Ko, Jeong Hee;Jeon, Yeon Jin;Choi, Yumi
    • Childhood Kidney Diseases
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    • 제23권2호
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    • pp.121-123
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    • 2019
  • Urinary tract infection is common in the pediatric population. The most common causative agents are bacteria, among which Escherichia coli is the most frequent uropathogen. Although fungal urinary tract infection is rare in the healthy pediatric population, it is relatively common among hospitalized patients. Fungus may be isolated from the urine of immunocompromised patients or that of patients with indwelling catheters. The most common cause of funguria is Candida albicans. Although more than 50% of Candida isolates belong to non-albicans Candida, the prevalence of non-albicans candiduria is increasing. Herein, we report a case of community-acquired candiduria in a 4-month-old immunocompetent male infant who had bilateral vesicoureteral reflux and was administered antibiotic prophylaxis. He was diagnosed with urinary tract infection caused by Candida lusitaniae and was managed with fluconazole.

비뇨기계 병원감염 통제를 위한 실험연구 -유치도뇨관을 삽입한 환자에게 외요도구간호를 실시한 실험군과 그 대조군의 요로감염율 비교- (The Control of Catheter -associated Urinary Tract Infection : An Experimental Nursing Study -This study examined the effect of daily meatal care on the urinary tract infection rate of an experimental group.-)

  • 백영주;양숙자;모경빈;최영희
    • 대한간호학회지
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    • 제19권3호
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    • pp.249-258
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    • 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.

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Chronic Infections of the Urinary Tract and Bladder Cancer Risk: a Systematic Review

  • Anderson-Otunu, Oghenetejiri;Akhtar, Saeed
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.3805-3807
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    • 2016
  • Literature on the relationship between recurrent urinary tract infections and urinary bladder carcinoma risk has been inconsistent. Therefore, we carried out this systematic review of observational studies to ascertain if there is any association between chronic urinary tract infection and urinary bladder carcinoma. A total of 10 databases were searched using Boolean: CINAHL, PUBMED, Google Scholar, Medline, Science Direct, SCIRUS, Cochrane, UK PubMed central, NHS evidence and WHO-website. The search yielded an initial hit of 3,518 articles and after screening and critical appraisal, seven studies were included for this review. Four articles reported an association between chronic urinary tract infections and bladder cancer while three concluded a weak or no association at least in one gender. Main findings in this review were that most of the studies reported an association between chronic urinary tract infections and bladder cancer risk. However, inferences about the causal association between chronic urinary tract infections and bladder cancer risk should be drawn cautiously considering the methodological limitations of case-control studies included in this review. Therefore, more empirical evidence is needed to determine the causal nature of relationships between chronic urinary tract infections and bladder cancer risk.

뇌졸중에 병발한 요로감염으로 인한 발열, 부종에 대한 마황가출탕 치험 1례 (A Case Of Treatment with Mahwanggachul-tang on Fever and Edema Due to Urinary Tract Infection Combined with Stroke)

  • 임제민;이아람;감철우;김원일
    • 대한한의학방제학회지
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    • 제19권1호
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    • pp.263-272
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    • 2011
  • Objectives : The purpose of this study is to report the improvement after treatment with Mahwanggachul-tang on fever and edema due to urinary tract infection combined with stroke. Methods : From December 8th to 22nd 2010, We treated a ischemic stroke patient having fever and edema due to urinary tract infection with Mahwanggachul-tang. We checked body temperature, intake-output, urine analysis and chest X-ray. Results : There were improvement on body temperature, Intake-output, urin analysis and chest X-ray. Conclusions : This report shows Mahwanggachul-tang has effectiveness on fever and edema due to urinary tract infection combined with stroke.

소아 요로감염의 임상 지침 (Guidelines for childhood urinary tract infection)

  • 이승주
    • Clinical and Experimental Pediatrics
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    • 제52권9호
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    • pp.976-983
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    • 2009
  • Urinary tract infection (UTI), the most common bacterial disease in childhood, is frequently associated with urinary tract anomalies (15-50%) and can induce renal scarring, which is a cause of hypertension and chronic kidney disease. Despite the high risk of renal scarring in infancy, the diagnosis may be delayed due to its nonspecific presenting symptoms; moreover, over-diagnosis is frequent due to the contamination of urine samples. The delay in diagnosis and treatment may induce sepsis or renal scar, while over-diagnosis is responsible for unnecessary antibiotic treatment and costly urinary imaging studies. UTI guidelines have been ever-changing for the past three decades, but some controversial issues remain. This article is a revision of the previous KSPN (Korean Society of Pediatric Nephrology) guideline and addresses the recent controversies concerning childhood UTI.