• 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.

• Journal of Microbiology and Biotechnology
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• v.13 no.4
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• pp.552-559
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• 2003

The FimH subunit of type 1-fimbriated Escherichiu coli (E. coli) has been determined as a major cause for urinary tract infections. Thus, to produce a possible vaccine antigen against urinary tract infections, the fimIH gene was genetically coupled to the ctxa2b gene and cloned into a pMAL-p2E expression vector. The chimeric construction of pMALfimH/ctxa2b was then transformed into E. coli K-12 TB1 and its nucleotide sequence was verified. A fusion protein, based on fusing adhesin to the cholera toxin subunit A2B (CTXA2B), was induced with 0.01 mM isopropyl-${\beta}-D-thiogalactoside$ (IPTG) for 4 h at $37^{\circ}C$ to yield a soluble fusion protein. The fusion protein was then purified by affinity chromatography. The expressed fusion protein was confirmed by SDS-PAGE and Western blotting using antibodies to the maltose binding protein (MBP) or the cholera toxin subunit B (CTXB), plus the N-terminal amino acid sequence was also analyzed. The orderly-assembled fusion protein was confirmed by a modified $G_{Ml}-ganglioside$ ELISA, using antibodies to adhesin. The results indicated that the purified fusion protein was an adhesin/CTXA2B protein containing E. coli adhesin and the $G_{Ml}-ganglioside$ binding activity of CTXB. Accordingly, this adhesin/CTXA2B protein may be a potential antigen for oral immunization against uropathogenic E. coli.

• Microbiology and Biotechnology Letters
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• v.50 no.1
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• pp.147-156
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• 2022

Urinary tract infections (UTIs) are one of the most common infections in different age groups, including children. Bacteria are the main etiological agents of UTIs. The aim of the present study was to isolate, identify, and determine the antibiotic susceptibility of bacteria isolated from children with UTIs from Baghdad, Iraq. Three hundred and two urine samples were collected from children aged 6 months to 12 years. The samples were cultured on blood agar and MacConkey agar. The selected colonies were subjected to biochemical tests and antibiotic susceptibility analysis using the Vitek^® 2 Compact automated microbial identification system. In this sample, 299 bacteria were identified, of which, 267 were gram-negative bacteria, and 32 were gram-positive bacteria. Escherichia coli (56%) was the most commonly isolated gram-negative bacteria, followed by Pseudomonas aeruginosa (14%), Enterobacter spp. (10.48%), Klebsiella pneumoniae (9.36%), Proteus spp. (7.8%), Acinetobacter baumannii (1.5%), and Morganella morganii (0.37%). Enterococcus faecalis (62.5%) was the most commonly detected gram-positive bacteria, followed by Staphylococcus aureus (37.5%). E. coli and P. aeruginosa were the most antibiotic-resistant bacteria. Among the tested antibiotics, meropenem showed 100% sensitivity, followed by imipenem (97.4%), amikacin (91.8%), and tobramycin (83.5%). In contrast, the high frequencies of resistance were observed with cefixime (93.2%), cefotaxime (78.7%), and ceftriaxone/cefotaxime (71.2%). In conclusion, carbapenems and aminoglycosides are highly recommended for the empirical treatment of UTIs, while, Quinolones, penicillins, and cephalosporins are not suggested. Frequent antibiotics susceptibility testing are warranted to determine the resistance pattern of UTI bacteria.

• Microbiology and Biotechnology Letters
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• v.50 no.2
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• pp.283-292
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• 2022

Colibactins (clb) and Cytotoxic Necrotizing Factors (cnf) are virulence factors that impact cell cycle through cellular differentiation, proliferation, and apoptosis. Urinary tract infections (UTIs) are the most common among type of infection among outpatients, with a lifetime incidence of about 60-65% in adult females. Here, we sought to isolate uropathogenic Escherichia coli (UPCE) from urine specimens and investigates the prevalence of clb A, B and cnf 1, 2 genes among these isolates. A total of 110 E. coli isolates were collected from patients with UTIs. All the isolates were examined for their hemolytic activity and only 46 isolates showed a halo zone of hemolysis on blood agar. The collected UPEC isolates were screened for the existence of clb A, B and cnf genes. The results revealed that out of 110 isolates, 28 harbored the clbA gene, 40 harbored clb B, and 24 isolates harboured cnf1. 13 isolates harbored clbA, clbB, and cnf1 genes, while no cnf2 gene was detected among isolates. The molecular detection revealed that 8 out of 28 hemolytic isolates carrying the clbA, 11 out of 40 were carrying clbB, 1 out of 24 were carrying cnf 1, and 5 out of 9 carrying clbA+clbB. Furthermore, 7 out of 13 isolates were hemolytic and carrying clbA, clbB, and cnf1 genes. Finally, we investigated the cytotoxicity of E. coli harboring clb and cnf genes, eukaryotic REF cells were exposed to E. coli producing colibactin, which induces DNA damage and leads to cell cycle arrest, senescence and death.

• Biomedical Science Letters
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• v.28 no.2
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• pp.127-136
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• 2022

Uropathogenic Escherichia coli (UPEC) is main causative agent of urinary tract infections. They are classified based on various types of O antigen. UPEC strains commonly possess many genes encoding virulece-associated factors. E. coli strains are generally divided into four main phylogenetic groups. The virulence factor (VF) profiles of UPEC are related with their O-serogroups in each strains. A total of 681 strains of UPEC clinical isolates were collected from Korean healthcare facility (1989: 123 strains and 2010-2014: 558 strains). The UPEC clinical isolates were analyzed by polymerase chain reaction (PCR) methods. A total of 14 O-serotypes (O1, O2, O4, O6, O7, O8, O15, O16, O18, O21, O22, O25, O75 and O83), 6 virulence factors (papC, fimG/H, sfaD/E, hly1, cnf1 and usp) and phylogenetic groups were identified. The most prevalent O-serogroups were O6 (11.1%) in 1989 UPEC strains and O25 (21.0%) in 2010-2014 UPEC strains. The identified VFs, phylogenetic groups in 1989 UPEC strains and 2010-2014 UPEC strains were fimG/H and B2 group. In this study, O6 serotype was revealed the close relationships with VFs. Also, the distribution of prevalence O-serogroups of UPEC has been changed from O6 to O25 and virulence of UPEC strains was increased during past twenty-one years.

• Clinical and Experimental Pediatrics
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• v.64 no.7
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• pp.347-354
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• 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.

• YAKHAK HOEJI
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• v.40 no.1
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• pp.95-101
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• 1996

The in vitro antibacterial activities of LB10522, a new catechol-substituted cephalosporin, were compared with those of cefpirome, ceftazidime, ceftriaxone, and cefoperaz one against clinical isolates and laboratory standard anaerobes. LB10522 had broad spectrum antibacterial activities against both gram-positive and gram-negative microorganisms. It was most active against gram-positve bacteria among the reference cephalosporins tested. Against gram-negative strains such as the family Enterobacteriaceae, LB10522 showed an activity comparable to that of cefpirome. But LB10522 was more potent than ceftazidime, ceftriaxone and cefoperazone. In particular, Pseudomonas aeruginosa was highly susceptible to LB10522, which was 32-fold and 64-fold more active than ceftazidime and cefpirome, respectively. Against anaerobic strains, the activity of LB10522 was similar to those of reference compounds. LB10522 exhibited potent therapeutic activities against experimental local infections in mice. The therapeutic effect of LB10522 against urinary tract infection (UTI) caused by P. aeruginosa 1912E in mice was superior to that of cefpirome. Against experimental respiratory tract infection (RTI) caused by K. pneumoniae DT-S in mice, LB10522 was as effective as cefpirome. The in vivo efficacy of LB10522 was correlated well with its in vitro activity.

• Advances in pediatric surgery
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• v.12 no.1
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• pp.115-125
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• 2006

Postoperative management of anorectal malformation consists of colostomy management and then management after definitive surgery. Colostomy management requires attention to certain details, i. e. complete decompression of the distal limb to avoid secondary megarectosigmoid and prevention and treatment of urinary tract infections in patients with rectourethral fistula. Management after definitive surgery requires the care of catheters placed in the rectourethral fistula or cloacal defect. Prevention and treatment of various complications after definitive operation, i. e. wound infection, anal stenosis or stricture, anal mucosal prolapse, and management of functional disorders, i.e. constipation, fecal incontinence and urinary incontinence are also necessary. In this review, recent trends for the prevention and treatment of the above mentioned problems after operation for anorectal malformation are presented.

• Childhood Kidney Diseases
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• v.5 no.1
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• pp.15-21
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• 2001

Purpose : Urinary tract infections (UTIs) of children require prompt and correct diagnosis and treatment to reduce the risk of renal damage. As a first step to improve the outcome of UTI in Korea, we investigated the practical variations in the methods of diagnosis, treatment, and evaluation of children with UTI and UTI prevention. Method :A questionnaire related to the individual policy on UTI diagnosis. treatment, imaging test, and prevention was submitted to 26 experts. Result Majority of the experts used bag-collected urine specimen for infants and mid-stream urine specimen for children for urinary culture. With a negative result of culture study, they diagnosed UTI when there was pyuria, positive results of the nitrite test, or bacteriuria. 80 $\%$ of experts prescribed prophylactic antibiotics after upper tract UTI. Operative treatment of vesicoureteral reflux (VUR) was indicated for children older than one or two years old with high-grade VUR, refractory breakthrough infections, or recurrent UTIs. Most of them performed kidney ultrasonography on the diagnosis of UTI and more than half of them evaluated children treated of UTI with vesicocystourethrogram and/or DMSA scintigraphy. Majority did not recommend circumcision. Half of the experts were screening siblings of VUR patients. Conclusion : Considering the variations exposed through this study systematic guidelines for management of children with UTI in Korean would be necessary. (J. Korean Soc Pediatr Nephrol 5 : 15-21, 2001)

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.67-73
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• 2010

Purpose : We aimed to compare the clinical features and antibiotic resistance of urinary tract infection (UTI) caused by pathogens other than E. coli (non-E. coli) with UTI caused by E. coli in children. Methods : We enrolled patients with culture-proven UTI, who were admitted to the study hospital from September 2008 to August 2009. We investigated clinical data of patients with UTI and antibiotic resistance of isolated strains. For comparison, patients were divided according by results of the urine culture into E. coli and non-E. coli UTI groups. Results : A total of 84 patients participated in this study. Twenty one cases (25.0%) were caused by non-E. coli pathogens. Frequency of non-E. coli UTI differed according to age and sex: 'male <6 months', 10.5%; 'male ${\geq}$6 months', 50.0%; 'female <6 months', 43.7%; and 'female ${\geq}$6 months', 25.0% (P=0.014). More patients who received previous antibiotic treatment (P=0.017), but fewer patients who showed hematuria (P=0.014) were included in the non-E. coli UTI group than in the E. coli UTI group. Comparison of antibiotic resistance showed that the non-E. coli UTI group possessed more strains that were resistant to cefazolin, cefotaxime, imipenem, trimethoprim/sulfamethoxazole (TMP/SMZ) and tetracycline than the E. coli UTI group (P<0.05). Conclusion : Increased incidence, different distribution by age and sex, and high antibiotic resistance of non-E. coli UTI should be considered in selection of empirical antibiotics for treatment of UTI in children.