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A Single Center Study of the Change of Antibiotic Resistance to the Causative Organisms of Urinary Tract Infection for Recent 10 Years
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Jung Man Kim, Sang Don Lee, Chul Hun Jang
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Korean J Urogenit Tract Infect Inflamm 2008;3(1):63-74. Published online April 30, 2008
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 Abstract
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- "Purpose: We studied the changes in the antibiotic resistance to the causative organisms of urinary tract infection (UTI) for recent 10 years in order to give some useful informations on the choice of adequate drugs in the treatment of UTI. Material and Methods: We retrospectively analysed 9,546 uropathogens and their antimicrobial resistance that had more than 105 cfu/ml in urine culture in 5,981 in- or out-patients from January 1996 to September 2005. Results: The incidence of UTI was highest in the 1st decade (20.3%). The common pathogens were E. coli (35.2%), Enterococcus (19.4%), Pseudomonas (10.5%), Staphylococcus (8.0%) and Klebsiella (6.7%) in order. The incidence of E. coli decreased from 38.3% in 1996 to 25.1% in 2005 but the incidence of Enterococcus and Pseudomonas increased from 17.4% to 27.5% and from 7.7% to 14.9%, respectively. For Gram negative isolates, the resistance to ampicillin was very high (81.8%) and the resistance to ciprofloxacin and trimethoprim/sulfamethoxazole (TMP/SMX) were 37.4% and 58.6%, respectively. For E. coli, the resistance of ampicillin, ciprofloxacin and TMP/SMX were 77.4%, 37.2% and 56.0%, respectively. Conclusions: E. coli was the most common organism causing UTI but we should be concerned about the increase of Gram positive organisms, especially Enterococcus. Resistance of ampicillin, TMP/SMX and ciprofloxacin at the empirical therapy for UTI should be reconsidered."
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Acute Epididymitis in Children: 10-Year Retrospective Study of Single Center
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Jung Man Kim, Chang Yell Lee, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):173-178. Published online October 31, 2007
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Abstract
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- "Purpose: We studied to describe clinical aspects, to assess the value of diagnostic tests and to determine conspicuous characteristics of acute epididymitis between children and adult. Materials and Methods: A total of 205 patients with acute epididymitis over a 10-year period were divided into 3 groups: group A (prepuberty; 49 patients), group B (puberty; 42 patients) and group C (adult; 114 patients). We analysed retrospectively the medical records: clinical features, laboratory tests, radiological examinations, accompanying diseases and treatment. Results: The mean ages were 6.5±2.7, 14.1±2.8, and 43.7±13.4 years in the group A, B, and C (p<0.001), respectively. Prevalence of symptoms including swelling, pain, tenderness and fever were not different among these 3 groups. Serum ESR and CRP levels were significantly higher in group C compare to group A and B (p=0.008 and p<0.001). On urinalysis, pyuria was presented 4 (8.2%), 5 (11.9%), and 19 patients (16.7%) in each group (p=0.341). However, there were only 4 positive urine cultures (1.8%): group A; 2 E. coli, group C; 2 Pseudomonas. All of patients performed by Doppler ultrasonography (CDUS) and testicular scan demonstrated the increased vascularity and isotope uptake, respectively. The concomitant diseases causing acquired epididymitis were predominent in the group C. The epididymectomy and scrotal exploration were performed in 0 (0.0%), 1 (2.4%), 1 (0.9%) patients, and in 4 (8.2%), 0 (0.0%), 2 (1.8%) patients in each group, respectively. Conclusions: Compare to the adults, for the diagnosis of acute epididymitis, CDUS and/or testicular scan were very useful, however serum ESR and CRP level, urinalysis and urine culture seem to be not useful in children. This study suggests that if there is no evidence of infections, empirical antibiotics treatment should not be recommended."
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