Urogenital Tract Infection

Sang Don Lee

31 Articles

The Urinary Microbiome: A Pediatric Urological Perspective: Sang Don Lee, Jae Min Chung; Urogenit Tract Infect 2022;17(3):61-70. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.61

Abstract PDF PubReader ePub: The human microbiome is currently being studied with increasing interest. The microbiome refers to the microorganisms living in the body and their genetic information. The human body is known to contain 1.3 to 10 times more microorganisms than human cells. The Human Microbiome Project was started in 2007 to characterize the human microbiome and analyze its role in human health and diseases. Based on the recent microbiome literature, alterations in the microbiome are associated with several non-urological diseases in pediatrics, such as infantile colic, necrotizing enterocolitis, asthma, atopy, obesity, type-1 diabetes, autism, atopic dermatitis, psoriasis, and bronchial asthma. While some urinary microbiome studies (including prostate cancer, bladder cancer, interstitial cystitis, urge urinary incontinence, overactive bladder, stone disease, and urinary tract infections) have been conducted in adults, there are very few pediatric urinary microbiome studies. This study reviews the role of the urinary microbiome in urinary tract diseases from a pediatric urological perspective.

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Risk Factors of Febrile Urinary Tract Infection after Ureteral Reimplantation in Infant: Seungsoo Lee, Jae Min Chung, Sang Don Lee; Urogenit Tract Infect 2020;15(2):33-37. Published online August 31, 2020; DOI: https://doi.org/10.14777/uti.2020.15.2.33

Abstract PDF PubReader ePub: Purpose: Children with febrile urinary tract infection (fUTI) and vesicoureteral reflux (VUR) show significant morbidity. Few studies have examined the incidence of fUTI after ureteral reimplantation for congenital urinary tract anomalies, particularly in infants. Therefore, this study examined the incidence and risk factors of fUTI after ureteral reimplantation in infants.
Materials and Methods: Children under one year of age, who underwent ureteral reimplantation from July 2017 to December 2018, were reviewed retrospectively. The patients’ data were analyzed to evaluate the predictors of fUTI after ureteral reimplantation.
Results: Ureteral reimplantation was performed in 16 patients (25 ureters) at a mean of 8.9±2.8 months. The preoperative diagnosis was VUR 14 (87.5%), obstructive megaureter 1 (6.3%), duplicated ureter 1 (6.3%). Postoperative fUTI occurred in five patients (31.3%) during the follow-up period (average 9.6±5.9 months, range 3-18 months). UTI occurred at 40.8±16.6 (17-61) days after surgery. Fourteen ureters were implanted with a ureteral catheter for three days, and 11 ureters were implanted with a double J ureteral stent for six weeks. The children’s age, sex, surgical method, renal scar, reflux grade, laterality, persisting VUR, and presence of double J ureteral stent were not predictive factors for postoperative fUTI.
Conclusions: The incidence of fUTI after ureteral reimplantation in infants was 31.3%, and all fUTI occurred within two months after surgery. The risk factors associated with fUTI after ureteral reimplantation could not be predicted.

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Analysis of Uropathogens of Febrile Urinary Tract Infection in Infant and Relationship with Vesicoureteral Reflux: Kyung Hwan Kim, Seung Hee Seo, Sang Don Lee, Jae Min Chung; Urogenit Tract Infect 2018;13(3):58-65. Published online December 31, 2018; DOI: https://doi.org/10.14777/uti.2018.13.3.58

Abstract PDF: Purpose: This study aimed to investigate the relationship between uropathogens of infants with febrile urinary tract infection (UTI) and vesicoureteral reflux (VUR).
Materials and Methods: We analyzed 308 infants hospitalized for febrile UTI between January 2010 and December 2015, and assessed the voiding cystourethrography (VCUG). The medical records, including clinical symptoms, laboratory findings, urinalysis, urine culture tests, ultrasound (US), dimercaptosuccinic acid scan, and VCUG, were retrospectively obtained. The incidences of VUR and high-grade VURs (III, IV, and V) were analyzed in 4 groups categorized by uropathogens and renal US findings.
Results: The mean age of 308 infants was 3.29±2.18 months. The male-to-female ratio was 3.46:1. In urine culture tests, 267 infants (86.69%) showed single bacterial uropathogen; Escherichia coli in 241 infants (78.25%) and non-E. coli uropathogens in 26 infants (8.44%). Multiple distinctive microorganisms were identified as causative uropathogens in 41 infants (13.31%). Abnormal findings of US and VCUG were identified in 216 and 64 patients, respectively. In 308 infants, the incidences of VUR and high-grade VUR were not different among the 4 groups. In 239 male infants, the incidences of high-grade VUR were higher in patients with non-E. coli single or multiple uropathogen and with abnormal US findings (p=0.042).
Conclusions: In male infants with non-E. coli uropathogen or multiple uropathogens and with abnormal US findings at febrile UTI, there was an increased chance of finding high-grade VURs on subsequent VCUG tests.

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Association between an Interleukin 4 Gene Polymorphism, rs2243268, and Urogenital Tuberculosis: Bongsuk Shim, Sang Don Lee, Tae-Hyoung Kim, Seung Il Jung, Won Yeol Cho, Gilho Lee; Urogenit Tract Infect 2018;13(2):35-39. Published online August 31, 2018

Abstract PDF: Purpose: Urogenital tuberculosis (UGT) is rarely reported in developed countries. This study evaluated the genetic susceptibility of Korean patients to UGT.
Materials and Methods: A total of 35 UGT patients who were confirmed pathologically, 44 intrapulmonary tuberculosis (IPT) patients who were confirmed radiologically, and 102 controls over a 6 year period were enrolled in this study. The region of rs2243268 in interleukin-4 (IL-4) gene was amplified from whole blood samples, and the DNA sequences were read using the Sanger method.
Results: Twenty women and 15 men were diagnosed with UGT. The occurrence of the CC, AC, and AA genotypes of rs2243268 were 26 (74.3%), 8 (22.9%), and 1 (2.9%), respectively, in UGT; 28 (63.6%), 15 (34.1%), and 1 (2.3%), respectively, in IPT; and 51 (50.0%), 45 (44.1%), and 6 (5.9%), respectively, in the control groups (p=0.115). The bivariate data of CC and AC/AA were 74.3% and 25.7% in UGT, 63.6% and 36.4% in IPT, and 50.0% and 50.0% in the control groups, respectively (p=0.029). The UGT was significantly different from the control group among the three genotypes (p=0.038, Fisher’s exact test) and bivariate genotypes (p=0.017, Fisher’s exact test). In addition, people carrying the CC genotype had a higher risk of UGT (odds ratios, 2.889; 95% confidence intervals, 1.233-6.770; p=0.015).
Conclusions: A single nucleotide polymorphism in the IL-4 gene, rs2243268, is associated with the development of clinical tuberculosis. The CC type of rs2243268 increases the risk of UGT significantly compared to the CA/AA type.

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The Antibiotic Susceptibility of Escherichia coli from Community-Acquired Uncomplicated Urinary Tract Infection: A Focused on Fosfomycin: Hyun-Sop Choe, Seung-Ju Lee, In Ho Chang, Tae-Hyoung Kim, Hong Chung, Jae Min Chung, Sang Don Lee, Jae Hung Jung, Ki Ho Kim, Seung Ki Min, Yong Gil Na, Hana Yoon, Ho Song Yu, Mi-Kyung Lee, Sun-Ju Lee; Urogenit Tract Infect 2017;12(2):77-81. Published online August 31, 2017

Abstract PDF: Purpose: To assess the antibiotic susceptibility of Escherichia coli from community-acquired uncomplicated urinary tract infection (UTI).
Materials and Methods: Between August and December of 2015, confirmed cases of E. coli as a pathogen of community-acquired uncomplicated UTI were collected and assessed for antibiotic susceptibility in 10 designated hospitals. Additional fosfomycin susceptibility test was performed by a central laboratory using the disk diffusion method.
Results: A total of 347 E. coli isolates were collected from urine samples of community-acquired uncomplicated UTIs patients. The susceptibility rates of antibiotics were as follows: amikacin 100.0% (347), imipenem 100.0% (347), ciprofloxacin 57.1% (198), cefotaxime 74.9% (260), ampicillin 30.0% (104), trimethoprim/sulfamethoxazole 66.9% (232), and fosfomycin 98.0% (340). All fosfomycin-resistant E. coli isolates were extended-spectrum β-lactamase (ESBL)-producing. In 85 cases of ESBL-producing E. coli, the fosfomycin susceptibility rate was 91.8% (78/85).
Conclusions: Fosfomycin may be a useful option for the treatment of community-acquired uncomplicated UTIs. Further studies evaluating the role of fosfomycin in the treatment of UTIs and its clinical efficacy are necessary.

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Infectious Complications after Prostate Biopsy: A Prospective Multicenter Prostate Biopsy Study: Eu Chang Hwang, Ho Song Yu, Seung Il Jung, Dong Deuk Kwon, Sun Ju Lee, Tae-Hyoung Kim, In Ho Chang, Hana Yoon, Bongsuk Shim, Kwang Hyun Kim, Donghyun Lee, Jung-Sik Huh, Dong Hoon Lim, Won Jin Jo, Seung Ki Min, Gilho Lee, Ki Ho Kim, Tae Hwan Kim, Seo Yeon Lee, Seung Ok Yang, Jae Min Chung, Sang Don Lee, Chang Hee Han, Sang Rak Bae, Hyun Sop Choe, Seung-Ju Lee, Hong Chung, Yong Gil Na, Seung Woo Yang, Sung Woon Park, Young Ho Kim, Tae Hyo Kim, Won Yeol Cho, June Hyun Han, Yong-Hyun Cho, U-Syn Ha, Heung Jae Park, The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII); Urogenit Tract Infect 2016;11(1):17-24. Published online April 30, 2016

Abstract PDF: Purpose: Recent studies have highlighted an increasing trend of infectious complications due to fluoroquinolone-resistant organisms among men undergoing transrectal prostate biopsy. This study evaluated the current incidence of infective complications after trans-rectal prostate biopsy for identification of risk factors in Korean men who received fluoroquinolone prophylaxis.
Materials and Methods: A prospective, multicenter study was conducted in Korea from January to December 2015. Prostate biopsies performed with fluoroquinolone prophylaxis during 3 months in each center were included. A pre-biopsy questionnaire was used for identification of patient characteristics. Clinical variables including underlying disease, antibiotic prophylaxis, enema, povidoneiodine cleansing of the rectum, and infectious complications were evaluated. The primary outcome was the post-biopsy infection rate after fluoroquinolone prophylaxis. Univariable and multivariable analyses were used for identification of risk factors for infectious complications.
Results: The study included 827 patients, of whom 93 patients (11.2%) reported receiving antibiotics in the previous 6 months and 2.5% had a history of prostatitis. The infectious complication rate was 2.2%. Post-biopsy sepsis was reported in 2 patients (0.2%). In multivariable analysis predictors of post-biopsy sepsis included person performing biopsy (adjusted odds ratio [OR], 4.05; 95% confidence interval [CI], 1.31-12.5; p=0.015) and operation history within 6 months (adjusted OR, 5.65; 95% CI, 1.74-18.2; p=0.004).
Conclusions: The post-prostate biopsy infectious complication rate in this study was 2.2%. Person performing biopsy (non-urologists) and recent operation history were independent risk factors for infectious complications after trans-rectal prostate biopsy.

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Predictive Parameters of Testicular Salvage of Pediatric Testicular Torsion: A 6-Year Experience of a Single Center: Seungsoo Lee, Bu Kyung Park, Moon Kee Chung, Jae Min Chung, Sang Don Lee; Urogenit Tract Infect 2016;11(1):25-29. Published online April 30, 2016

Abstract PDF: Purpose: We evaluated parameters associated with testicular salvage in boys with testicular torsion.
Materials and Methods: During 2009-2014, 19 boys younger than 18 years old underwent emergency surgery for testicular torsion in our hospital. Age, chief complaint, laterality of the torsion, physical appearance, ultrasonographic results, duration between the onset of symptoms and hospital visit, duration between the onset of symptoms and start of surgery, intraoperative appearance, surgical method (orchiopexy or orchiectomy), and any postoperative complications were analyzed retrospectively. Cases were categorized according to salvageable testes (n=14) or unsalvageable testes (n=5) groups based on testes viability.
Results: The mean age was not significantly different between the two groups. All patients were diagnosed using color Doppler ultrasonography of the scrotum. Six (42.9%) boys in the salvageable testes group and all five in the unsalvageable testes group were transferred from other clinics or hospitals (p=0.026). The mean duration between the onset of symptoms and hospital visit was 925 minutes in the salvageable testes group and 3,488 minutes in the unsalvageable testes group (p=0.042), and the mean duration between the onset of symptoms and start of surgery was 1,131 minutes in the salvageable testes group and 3,777 minutes in the unsalvageable testes group (p=0.042).
Conclusions: There was a high possibility that orchiectomy was required if surgery was delayed. However, even when a boy is admitted to the hospital more than 24 hours after the onset of symptoms, the testis can still be viable provided the surgery is performed as quickly as possible.

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Characteristics of Patients Who Visited the Emergency Room after Prostate Biopsy: Single Center Retrospective Study: Seung Chan Jeong, Seungsoo Lee, Jae Min Chung, Sang Don Lee; Urogenit Tract Infect 2015;10(2):120-125. Published online October 31, 2015

Abstract PDF: Purpose: To educate patients and prevent biopsy-related complications, it is helpful to understand the causes for visiting the emergency room (ER). Therefore, we want to analyze the causes and factors of complications that cause patients to visit the ER after prostate biopsy.

Materials and Methods: We conducted a study of in-patients who visited the ER of Pusan National University Yangsan Hospital after prostate biopsy from December 2008 to July 2015. Age, postoperative interval before visiting the ER, Charlson comorbidity index (CCI) score, symptoms in ER, prostate size, pathologic result, and number of biopsy cores were analyzed retrospectively.

Results: Among all 1,694 cases of patients who had undergone prostate biopsies during a 7-year period, only 37 patients (2.2%) visited the ER. Diabetes mellitus (DM) is the most common underlying disease among patients with accompanying infection-related symptoms compared to patients with accompanying non-infection- related symptoms (p＜0.001). In univariate analysis, DM (p=0.004) and CCI score (p=0.030) were statistically significant risk factors for infection, but only DM was significant in multivariate analysis (p=0.004). Prostate size (p=0.044) was a significant risk factor for acute urinary retention (AUR) in univariate analysis, but not statistically significant in multivariate analysis. CCI score was a statistically significant risk factor for bleeding (p=0.005 [univariate], 0.035 [multivariate]).

Conclusions: AUR after transrectal ultrasound-biopsy is the most common reason for visiting the ER. CCI score showed correlation with bleeding and DM showed correlation with infection. Consideration of risk factors of complications after prostate biopsy will be helpful to the patients in the treatment and prevention of complication.

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Is Postoperative Prophylactic Antibiotics Necessary for Pediatric Scrotal and Inguinal Outpatient Surgeries?: Seungsoo Lee, Chang Soo Park, Sung Hye Jo, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2014;9(2):111-114. Published online October 31, 2014

Abstract PDF: Purpose
Excess usage of antibiotics can cause complications of antibiotics and rise of antibiotic-resistant strains. However, guidelines for antibiotic prophylaxis differ between countries. We evaluated necessity of postoperative prophylactic antibiotics for pediatric patients who underwent scrotal and inguinal outpatient surgeries. Materials and Methods: From April 2011 to April 2014, 725 patients (mean age, 30.5±21.6 months) who underwent outpatient surgery (hydrocelectomy, orchiopexy, orchiectomy, and inguinal herniorrhaphy) were evaluated. In group 1 (556 cases), each patient had intravenous antibiotic prophylaxis only preoperatively. In group 2 (169 cases), each patient had intravenous antibiotic prophylaxis pre- and post-operatively. In group 1 and group 2, we analyzed postoperative complications including wound dehiscence, fever, skin erythema, pain, pus, and diarrhea with medical records. Results: In group 1 and group 2, mean age was 30.4±21.7 months (5.0-108.0 months) and 30.8±21.2 months (7.0-108.0 months), respectively. In group 1 and group 2, the mean operative time was 29.6±2.4 minutes and 29.7±2.5 minutes, respectively. The differences of mean age and mean operative time were not statistically significant (p=0.82 and p=0.77, respectively). Nine patients in group 1 and two patients in group 2 had postoperative complications. The difference between two groups was statistically insignificant (p=0.69). According to age and operation, the differences of postoperative complications were not statistically significant. However, in patients under 2 years old, more complications tended to occur in group 1 than in group 2. Conclusions: Postoperative prophylactic antibiotics may not be necessary for pediatric scrotal and inguinal outpatient surgeries.

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Incidence and Risk Factors of Urinary Tract Infection after Endoscopic Therapy for Vesicoureteral Reflux in Children: Ja Yoon Ku, Bu Kyung Park, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2014;9(1):34-38. Published online April 30, 2014

Abstract PDF: Purpose
The purpose of this study is to evaluate the incidence and risk factors of febrile urinary tract infection (UTI) after endoscopic therapy for vesicoureteral reflux (VUR).
Materials and Methods: Analysis of the clinical data of 88 children (128 refluxing renal units; male 60%, female 40%) in a single institution during March 2011-June 2013 including age, gender, sorts and volume of agent for injection, preoperative VUR grade, recurrent UTI, bladder dysfunction, nephropathy, postoperative VUR, urinalysis, and urine culture results was performed retrospectively. All patients were followed for three to 62 months (average 25 months).
Results: After the first injection, the complete resolutions rate of VUR (by ureter) was 72.7%, consisting of grade I 4 (90%), grade II 11 (84.6%), grade III 29 (76.3%), grade IV 33 (66%), and grade V 93 (72.7%) ureters. Preoperative UTI and febrile UTI were present in 81 (92.0%) and 49 patients (55.7%), respectively. Preoperative recurrent UTI and febrile UTI were observed in 53 (60.2%) and 30 patients (34.1%), respectively. Postoperative UTI and febrile UTI occurred in eight (9.1%) and in five patients (5.7%), respectively. In multivariate analysis, only preoperative recurrent UTI (odds ratio [OR], 0.17; p=0.04) and bladder trabeculation (OR, 0.104; p=0.038) were independent variables after endoscopic therapy.
Conclusions: Our data support that the successful endoscopic correction of VUR is associated with a low incidence of febrile UTI. The highest risk factor for post injection UTI is preoperative recurrent UTI and bladder dysfunction. Therefore, patients with preoperative recurrent UTI and bladder dysfunction require careful observation after endoscopic therapy for VUR.

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The Difference of Microorganism and Antibiotics Resistance between Adults and Children with Urinary Tract Infection: Hyung Jong Nam, Seung Chan Jeong, Jong Youn Yi, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2012;7(2):136-141. Published online October 31, 2012

Abstract PDF: Purpose
Urinary tract infection (UTI) is one of the most common infectious diseases in children and adults. It is widely known that most UTI is caused by E. coli. In most cases for those who underwent UTIs, empirical antibiotics were treatment of choice. But resistance of empirical antibiotics is increasing gradually. The proper use of antibiotics is essential in the clinical field. We evaluated the antibiotic resistance of organisms causing UTIs in children and adults patients to provide the proper use of empirical antibiotics.
Materials and Methods: From January 2011 to December 2011, 749 cases (mean age was 27.9±30.2years) who underwent positive urinary culture tests were evaluated. The age, sex, results of urine dipstick and microscopic tests, urine culture, and antibiotics resistance were reviewed.
Results: 460 men and 289 women were evaluated. Adults were 310 cases (41.4%) and children were 439 cases (58.6%). Pathogens from the results of urine culture were E. coli (35.7%), Enterococcus species(25.8%), Klepsiella (12.9%). Antibiotics resistance rate of all pathogens was 29.8% and Pseudomonas(36.1%), with E. coli (32.8%) having the highest resistance rate of all. Ampicillin (61.8%), trimethoprim/sulfamethoxazole (42.6%), and penicillin (39.4%) showed higher resistance rates than other antibiotics. The multi-drug resistance rate was 17.8% in total, adults were 17.4%, and children were 18.1%. Female urine RBC and urine WBC counts were ssociated with UTIs from a pathogen which has resistance at to at least one of the antibiotics in adults. On the other hand, older age, urine leukocyte esterase and urine RBC count was associated with antibiotics resistance in children.
Conclusions: Gram positive microorganisms including E. coli were the most common pathogen of UTIs both in adults and children. Therefore, quinolones and cephalosporins are widely used in UTIs, however antibiotic sensitivity was reduced in this study and there was no difference in adults and children. The sensitivity and drug resistance were changing steadily, affecting many factors and various pathogens gave rise to UTIs. Therefore considerations of many factors of sensitivity to antibiotics are needed.(Korean J UTII 2012;7:136-141)

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Trial for Clinical Guideline of the Use of Prophylactic Antibiotics in Pediatric Urologic Outpatient Surgery: Hyung Jong Nam, Seung Chan Jeong, Mi Yeon Kong, Keum Seob Lee, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2012;7(1):50-55. Published online April 30, 2012

Abstract PDF: "Purpose: Proper use of antibiotics is essential in the clinical field. The overuse of antibiotics can be one of the causes for resistance. However, there is a lack of guideline to a valid method of prophylactic antibiotics in surgery. We evaluated the evidence on the suitable prophylactic antibiotics usage to prevent perioperative infection, when performing pediatric urologic outpatient surgery. Materials and Methods: From December 2010 to may 2011, 70 cases (mean age was 3.5±3.23 years) who underwent outpatient operation approached inguinal or scrotal incision were evaluated. In group 1, intravenous antibiotic prophylaxis was done only preoperatively. In group 2, intravenous antibiotics were administrated pre- and post-operative, each. In group 3, beside pre- and post-operative intravenous antibiotic prophylaxis, additional oral antibiotics were medicated for 3 days after discharge from the hospital. Further, in group 4, beside pre- and post-operative intravenous antibiotic prophylaxis, oral medication was administered until 7 days after discharge. Skin redness, pain, wound dehiscence, fever, gastrointestinal disturbance, and etc., were examined postoperatively. Results: Slight skin redness was observed in 4 cases (23.5%), 2 cases (10.5%), 1 case (7.1%), and 0 case (0.0%) in each group, but there is no need to treatment. There is no case who feels pain on the incision site of each group. Wound dehiscence occurred in one case in group 1 (5.9%) and group 3 (7.1%), respectively. There were no association with wound infection between each group, and wound infection was recovered spontaneously. Two cases (11.8%), 1 case (5.3%), 0 case(0.0%), and 3 cases (15.0%) complained with fever in each group. Diarrhea was observed in 2 cases (13.3%) and 4 cases (20.0%) in group 3 and 4, respectively. Conclusions: There were no differences in prophylactic effect to prevent infection in each group. Group 1 showed a lower incidence of diarrhea than group 3 or 4, but other adverse effects were not different among the groups. Therefore, it is sufficient to use antibiotics preoperatively for prophylactic purpose in pediatric urologic outpatient surgery."

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Clinical Outcome of Acute Bacterial Prostatitis; A Multicenter Study: Seong Ju Lee, Jin Mo Koo, Bong Suk Shim, Yong Hyun Cho, Chang Hee Han, Seung Ki Min, Sung Joo Lee, Hwan Cheol Son, Jun Mo Kim, Jong Bo Choi, Tae Hyoung Kim, Sang Kuk Yang, Kil Ho Lee, Yong Kil Na, Sung Ho Lee, Hee Jong Jung, Seung Il Jung, Chul Sung Kim, Jae Min Chung, Young Jin Seo, Won Yeol Cho, Kweon Sik Min, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2011;6(2):165-170. Published online October 31, 2011

Abstract PDF: "Purpose: Proper guidelines concerning antibiotic administration for acute bacterial prostatitis (ABP) are unclear. We retrospectively analyzed treatment status and clinical outcomes to establish a proper treatment guideline. Materials and Methods: The clinical records of 669 patients from 21 hospitals diagnosed with ABP were reviewed. Prior manipulation, antibiotics administration, mean length of treatment, complication and procedure were analyzed. Results: The mean age of 538 patients (80.4%) without manipulation (group 1) and 131 patients (19.6%) with manipulation (group 2) was 58.3 years (range 19-88 years). Transrectal prostate biopsy was the most common cause of acute bacterial prostatitis (n=66; 50.4%). Of the clinical symptoms in the non-manipulation and manipulation groups, fever was most common (88.2% and 86.3%, respectively). Acute urinary retention (14.3% and 28.1%, respectively) was significantly increased in the manipulation group (p<0.05). Escherichia coli was the most frequently isolated bacterium from urine (72.0% and 66.7% of cases, respectively). Mean length of treatment was 6.5days and 7.9days, respectively; the difference was significant (p<0.05). Combination antibiotic therapy with third generation cephalosporin+aminoglycoside was used in 49.3% and 55.5% of cases, respectively. For single antibiotic therapy, second generation quinolones were used the most (35.5% and 34.3%, respectively). Sequale occurred in 29 group 1 patients (5.4%) and 20 group 2 patients (15.3%); the difference was significant (p<0.05). Conclusions: Prior manipulation was associated with 20% of ABP patients. Regardless of manipulation, clinical outcome was similar after treating with appropriate antibiotics."

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Febrile Urinary Tract Infection in Infants: Comparative Analysis between Primary and Recurrent Infection: Suk Gun Jung, Do Hoon Kong, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2011;6(2):186-191. Published online October 31, 2011

Abstract PDF: "Purpose: Febrile urinary tract infection (UTI) is common in infants and is associated with the risk for renal scarring and long-term complications. We retrospectively investigated the risk factors for recurrent UTI in infants with febrile UTI. Materials and Methods: We identified 108 infants (mean age 4.5±3.2 months; range 1-12 months) with febrile UTI who visited the emergency room from January, 2007 to December, 2010. We retrospectively reviewed sex, age, urine analysis, pathogen, leukocytosis, C-reactive protein (CRP), hydronephrosis, hydronephrosis grade and severity, vesicoureteral reflux (VUR), VUR grade and severity. We performed comparative studies of infants with recurrent UTI (group A; n=20, 18.5%) and primary UTI (group B; n=88, 81.5%). High-grade hydronephrosis and high-grade VUR were both defined as grade 3 or higher. Results: In 108 infants with febrile UTI, the male to female ratio was 3.2:1 (82 boys, 26 girls). On cross analysis of group A and B, there was no significant difference according to sex, age, CRP level in serum, leukocytosis and inflammation markers in urine analysis (p>0.05). Comorbidity of hydronephrosis and VUR was 52.8% (n=57) and 13.9% (n=15), respectively. Group A had more high grade hydroneprhosis, high grade reflux, bilateral reflux and a non-Escherichia coli strain in the urine culture compared with group B (p<0.05).The presence and laterality of hydronephrosis was not significantly different (p>0.05). Conclusions: During the first year after birth, high grade VUR, bilateral VUR, and a non-E. coli strain in the urine culture significantly increases the risk of recurrent UTI. Therefore, in infants with febrile UTI, imaging studies and urine culture are important for evaluation of recurrence probability."

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Correlation between Genitourinary Mycoplasmas and Chlamydia Infection and Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Suk Gun Jung, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2011;6(1):67-72. Published online April 30, 2011

Abstract PDF: "Purpose: Chronic prostatitis frequently occurs in men of all ages. Recent studies suggest that fastidious microorganisms may play a role in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The aim of this study was to investigate if correlation exists between genitourinary Mycoplasmas and Chlamydia infections and CP/CPPS. Materials and Methods: We evaluated Mycoplasmas and Chlamydia prostatitis in 222 patients diagnosed with CP/CPPS from November 2008 to January 2011 by using the Chlamydia and Mycoplasma IST2 kits. Results: Of the 222 patients, 33 (14.9%) and 189 (85.1%) were respectively classified category IIIa (inflammatory CP/CPPS) and IIIb (non-inflammatory CP/CPPS). On kit tests, 10 (30.3%) of the 33 category IIIa and 55 (29.1%) of the 189 category IIIb cases were positive for causative microorganism. Conclusions: The results suggest close correlation between genitourinary Mycoplasmas and Chlamydia infections and CP/CPPS. In addition, the Chlamydia and Mycoplasma IST2 kits may be useful for simple detection of fastidious microorganisms in CP/CPPS."

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The Treatment of Emphysematous Pyelonephritis: Availability of Percutaneous Renal Drainage and Broad-spectrum Antimicrobials: Suk Gun Jung, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2010;5(2):193-198. Published online October 31, 2010

Abstract PDF: "Purpose: The therapeutic approaches to patients with emphysematous pyelonephritis remain controversial. We evaluated the usefulness of percutaneous drainage and broad-spectrum antimicrobials in patients with emphysematous pyelonephritis. Materials and Methods: From January 2001 to May 2010, 17 patients (14 females and 3 males) with emphysematous pyelonephritis (EPN) were managed at our institution. We retrospectively reviewed patient characteristics, causative pathogens, treatment methods, hospital stay duration, and treatment outcomes. The diagnosis of EPN was confirmed by the presence of intraparenchymal and/or perinephric gas burbles in imaging studies. Treatment modalities were consisted of emergency nephrectomy in 7 patients (Group A), percutaneous renal drainage in 6 patients (Group B) and medical therapy only in 4 patients (Group C). Results: The mean age of total patients was 58.4±14.8 (38-84) years. The most common underlying disease was diabetes. Serum blood sugar levels were not appropriately controlled in 12 among 14 diabetics. The cure rates and mean hospital stay in Groups A, B and C were 85.7%, 83.3%, and 30 days, 12 days, respectively. The mortality rates were 50% in type I and 37.2% in type II, according to the computed tomography findings. Conclusions: Combining broad-spectrum antibiotic therapy with percutaneous renal drainage is a safe and effective treatment of emphysematous pyelonephritis, especially in high-risk patients for whom nephrectomy under general anesthesia are not feasible."

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Clinical Guideline of Genital Herpes Virus Infection: Jong Kil Nam, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2010;5(1):18-26. Published online April 30, 2010

Abstract PDF: Genital herpes is one of the most common sexually transmitted diseases, While genital herpes can present with self limiting genital lesions. Many such persons have mild or unrecognized infections but shed virus intermittently in the genital tract. It is incurable and persists during the lifetime of the host, often in latent form. Treatment can be expected to reduce the formation of new lesions, the duration of pain, the time required for healing and antiviral shedding. However, antiviral agents do not cure Human simplex virus infections, but rather offer clinical benefits to the majority of symptomatic patients and is the mainstay of management. Our review is to summarize the treatment and management of genital herpes, which is to help patients deal with the infection and be prevented from sexual and perinatal transmission.

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Clinical Characteristics of Children with Febrile Urinary Tract Infection: Chang Soo Park, Seok Gun Jung, Jae Hyun Ahn, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2010;5(1):57-62. Published online April 30, 2010

Abstract PDF: "Purpose: Knowledge of baseline risk of urinary tract infection (UTI) can help clinicians make informed diagnostic and therapeutic decisions. We evaluated the clinical features of children with febrile UTI. Materials and Methods: We identified 141 patients with febrile UTI, who visited for treatment. We retrospectively reviewed the sex, age, hydronephrosis, vesicoureteral reflux (VUR), concomitant disease, previous urologic surgical history, prophylactic antibiotics, voiding symptom, pathogen, used antibiotics and antibiotics resistance. Results: In 105 infants with febrile UTI who were 12 months or less, the male to female ratio was 3:1 (79 boys, 26 girls), which showed a definite male predominance. But, female children had a relatively high prevalence rate of febrile UTI, especially after the first year of life. Comorbidity of hydronephrosis was 38.1%. The most prenatal hydronephrosis persisted until presenting febrile UTI. Comorbidity of VUR was 26.1%. There was no significant difference between the prevalence of febrile UTI and the use of prophylactic antibiotics according to the VUR grade (p>0.05). The most common pathogen was E. coli (70.2%), the most commonly used antibiotics was cefotaxime (79.4%) and the most commonly resistant antibiotics was ampicillin (77.9%). Conclusions: Our results of male to female ratio according to the age are consistent with the data from large epidemiologic UTI studies. Febrile UTI of infant significantly correlated with hydronephrosis and VUR. Understanding pathogen and resistance is mandatory."

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Pregnancy and Urinary Tract Infection: Tae Nam Kim, Dong Gil Shin, Sang Don Lee, Jeong Zoo Lee; Korean J Urogenit Tract Infect Inflamm 2009;4(2):141-149. Published online October 31, 2009

Abstract PDF: Urinary tract infections (UTIs) represent the most common bacterial infection in pregnant and non-pregnant women. Physiologic changes of pregnancy increase a woman’s susceptibility to UTIs. Progesterone effects and mechanical compression by the gravid uterus impair emptying of the bladder and lead to increased bladder residual volume and vesicoureteral reflux. Relative stasis of urine in the ureters results in hydronephrosis. Furthermore, pregnancy-related changes in glomerular filtration rate increases the urinary glucose concentration and alkalinity, thereby facilitating bacterial growth. The signs and symptoms of UTIs vary by the type of infection. UTIs in pregnancy is classified by the site of bacterial proliferation as follows: asymptomatic bacteriuria, cystitis, pyelonephritis.

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Clinical Features according to Co-morbidity in Patients Visiting Emergency Room due to Acute Hemorrhagic Cystitis: Hong Koo Ha, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2009;4(2):184-189. Published online October 31, 2009

Abstract PDF: "Purpose: To evaluate the clinical features according to co-morbidity in patients with acute hemorrhagic cystitis who visited the emergency room. Materials and Methods: We evaluated 60 patients who visited the emergency room due to acute hemorrhagic cystitis symptoms. We evaluated voiding and storage symptoms, urine analysis, urine culture, and presence of co-morbidities, and analyzed clinical features between group of presence of co-morbidity (group I) and absence of co-morbidity (group II) through review of medical records. Results: The mean age of 60 patients was 55.3±22.3 years (19-84) including 14 male (23.3%) and 46 female (76.7%). The mean age of group I (n=37) and II (n=23) were 62.9±19.8 (22-84) and 43.4 ±17.8 years (19-74), respectively (p=0.102). The most common clinical symptom was dysuria (35.0%) followed by frequency (11.7%) and urgency (3.3%). Pyuria more than 5 WBC/HPF in urine was revealed in 36 patients (60.0%): 22 (59.5%) and 14 (60.8%) in group I and II, respectively (p>0.05). Positive urine culture was found in 25 patients (41.7%): 18 (81.8%) in group I and 7 (18.4%) in group II, respectively (p<0.05), and cultured organisms were E. coli (68.0%), Entrococcus (20.0%), Pseudomonas (4.0%) and Sphingomonas (4.0%). Conclusions: Patients with acute hemorrhagic cystitis were more frequently found in female. The most common symptom was dysuria and more than half of the patient showed positive urine culture. Positive urine culture was more frequently revealed in patients with co-morbidity."

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Effect of Associated Diseases to Renal and Perirenal Abscesses: Dong Gil Shin, Hong Koo Ha, Jae Min Chung, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2009;4(2):202-209. Published online October 31, 2009

Abstract PDF: "Purpose: We analyzed the clinical experiences of patients with renal and perirenal abscesses during the last 10 years according to associated diseases. Materials and Methods: We reviewed the medical records of 63 patients with renal, perirenal, and mixed abscesses treated at two hospital from January 1999 to August 2009. The patients were divided into 3 groups: group A consisted of 11 patients without associated diseases, group B consisted of 31 patients with nonurological associated diseases and group C consisted of 21 patients with urological associated diseases. Results: A male to female sexual ratio of 63 patients was 1:2, and the mean age was 51.4±15.2 years, respectively. The most common associated diseases were diabetes mellitus (39.7%) and liver disease (19.0%). The most common urological associated diseases were nephrolithiasis (11.1%) and ureteral obstruction (7.9%). Fever or flank pain were the common symptom. The most common isolated uropathogen in urine, blood and pus culture was E. coli. The hospitalized, clinical and laboratory improvement duration of group A was significantly shorter than group B and C, respectively. The hospitalized, clinical and laboratory improvement duration was not significantly different between group B and C. Most patients are cured or improved on discharge from hospital in all abscesses. Conclusions: We suggest that the renal and perirenal abscesses with associated diseases needs longer hospitalized days and more intensive treatment than that without associated diseases."

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Comparison of Prostatic Biopsy Results according to Patterns of Prostate Specific Antigen after Antibiotic Therapy in Chronic Prostatitis Patients: Hong Koo Ha, Sung Woo Park, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2008;3(2):204-209. Published online October 31, 2008

Abstract PDF: "Purpose: We investigated the prostatic cancer rate according to patterns of PSA after antibiotics medication. Materials and Methods: Ninety-five patients with lower urinary tract symptoms (LUTS) and pyuria were treated with quinolone. Pyuria defined as more than 5 WBC/HPF in expressed prostatic secretion or VB3. We evaluated serum PSA level before and after antibiotic treatment and prostatic biopsy results in patients without decreased PSA under 4ng/ml. We compared prostatic cancer rate between 23 patients with decreasing PSA but above 4ng/ml (group A) and 22 patients without decreasing PSA than premedication (group B). Results: Of the 96 patients, 51 patients (53.1%) demonstrated serum PSA decreased lower than 4ng/ml. The remaining 45 patients were underwent prostate biopsy and prostatic cancer was found in 6 patients. Mean age and mean prostate volume in group A and group B were 61.4±12.7years, 61.9±10.4years (p=0.702) and 32.0±8.7gm, 31.7±5.6gm (p=0.532), respectively. Mean serum PSA before and after treatment were 7.84±2.97 ng/ml, 8.05±3.62ng/ml (p=0.246) and 4.53±2.33ng/ml, 8.55±3.25 (p=0.042) in group A and B, respectively. Positive predictive value for prostatic cancer increased from 0.063 to 0.133 in pretreatment and posttreatment patients (p=0.644) and from 0.043 to 0.227 in group A and B, respectively (p=0.039). Conclustions: Antibiotic treatment can decrease the serum PSA for chronic prostatitis and improve positive predictive value for prostatic cancer. Therefore we should consider prostate biopsy in patient without decreasing PSA after antibiotic medication."

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Cystic Renal Cell Carcinoma Mimicking a Renal Abscess: Jae Min Chung, Kyu Seop Kim, Seong Ju Kim, Byung Ju Sung, Sang Don Lee, Seong Choi; Korean J Urogenit Tract Infect Inflamm 2008;3(2):249-252. Published online October 31, 2008

Abstract PDF: Cystic renal cell carcinoma is one form of renal cell carcinoma. The radiographic and pathologic findings of cystic renal cell carcinoma are often more confusing and less specific than the findings of solid renal cell carcinoma. We report a case of cystic renal cell carcinoma mimicking a renal abscess.

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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: Jung Man Kim, Sang Don Lee, Chul Hun Jang; Korean J Urogenit Tract Infect Inflamm 2008;3(1):63-74. Published online April 30, 2008

Abstract PDF: "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: Jung Man Kim, Chang Yell Lee, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(2):173-178. Published online October 31, 2007

Abstract PDF: "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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Clinical Experience of Fournier's Gangrene: A Twenty Year Retrospective Analysis: Won Hee Chon, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(2):184-189. Published online October 31, 2007

Abstract PDF: "Purpose: Fournier's gangrene is aggressive necrotizing fasciitis of the scrotum, penis or perineum with a fatal synergistic polymicrobial infection. we evaluated the clinical outcome and management of patients with Fournier's gangrene. Material and Methods: Total of 23 cases of Fournier's gangrene treated in our hospital during the last 20 years were evaluated retrospectively through medical records such as onset season, department and diagnosis at first visit, time to diagnosis, laboratory finding, co-existing disease, prodromal symptom, hospital stay, treatment methods and outcome. Results: The patients' ages ranged between 39 and 83 years old (mean 63.2). There was no relation between onset of Fournier's gangrene and onset season. The usual prodromal symptoms were lower abdominal and inguinal pain. The co-existing disease included diabetes mellitus (9 cases, 34.7%), chronic liver disease (2 cases, 7.7%), pulmonary tuberculosis (2 cases, 7.7%), hemorrhoid (2 cases, 7.7%), debility (2 cases, 7.7%), paraplegia (1 case, 3.8%), malignant disease (1 case, 3.8%), urethral stricture (1 case, 3.8%) and hypertension (1 case, 3.8%). Contributing factors to establish infection were traumatic injury, urethral catheterization, hemorroid and peritonitis for 3, 2, 2 and 1 patients, respectively. Accuracy of diagnosis at the first visit was 81.3% in urologic, and 14.3% in non-urologic departments. Single and multiple infection were occurred in 16 (76.2%) and 5 (23.8%) patients, respectively, and E. Coli was most common causative microorganism. In the laboratory tests, leukocytosis (mean WBC: 13.1×103/ul), hypoalbuminemia (mean albumin: 2.6mg/dl) and increase of C-reactive protein (mean CRP: 16.4mg/dl) were characteristic. All patients were treated with triple broad spectrum antibiotics with wide surgical debridement. Cysotstomy and colostomy were additionally done in 13 (56.5%) and 5 (21.7%) patients, respectively. There was no death after final management. Conclusion: Early diagnosis and aggressive treatment with empirical triple antibiotics and wide debridment of devitalized tissue can reduce the mortality and bring a good outcome."

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Renal Abscess Treated with Double J Catheter Insertion: Jae Min Chung, Seong Ju Kim, Byung Ju Sung, Sang Don Lee, Seong Choi; Korean J Urogenit Tract Infect Inflamm 2007;2(2):217-220. Published online October 31, 2007

Abstract PDF: Renal abscess is uncommon and has variable symptoms of insidious onset. The most common pathogens are Escherichia coli. The patients with renal abscess usually present with fever, chills, abdominal or flank pain, and occasionally weight loss and malaise. Renal abscesses can be treated in various fashions. In these patients, renal abscess with hydronephrosis that does not respond to antimicrobial therapy was improved with double J catheter insertion.

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HIV/ADIS and Sexually Transmitted Diseases: Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):33-39. Published online May 31, 2007

Abstract PDF: The number of people living with HIV/AIDS continued to grow, estimated to be 39.5 million as of the end of 2006, while 4.3 million people were newly infected in 2006. High risk behaviors (intravenous drug use and unprotected sex bewteen men or with paid sex workers) are the predominent route of transmission. The close relationship between HIV/AIDS and sexually transmitted diseases (STDs) have been well known. Earlier diagnosis and treatment of STDs can be an effective tool in preventing the spread of HIV/AIDS. An understanding of the relationship between STDs and HIV/AIDS can help in the development of effective HIV/AIDS prevention programs for persons with high-risk sexual behaviors. We need to keep in mind that HIV/AIDS is expected to continued to grow in the foreseeable future in Korea as well as globally unless drastic efforts are made to prevent or manage STD adequately and to spread an understanding of the relationship between STDs and HIV/AIDS.

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Multicenter Clinical Outcome of Gatifloxacin for Chronic Prostatitis (NIH Category II or IIIa) in Korea: Sang Don Lee, Seung Ju Lee, Tae Kon Hwang, Duck Ki Yoon, Kyu Sung Lee, Luck Hee Sung, Myung Soo Choo, Bong Suk Shim, In Rae Cho, Min Eui Kim, Soo Bang Ryu, Chul Sung Kim, Young Gon Kim, Chun Il Kim, Hyun Yul Rhew, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(1):53-60. Published online May 31, 2007

Abstract PDF: "Purpose: The objective of this study was to investigate the efficacy and safety of gatifloxacin for patients with chronic prostatitis (NIH category II or IIIa) in Korean urologic practice. Materials and Methods: A total of 16 outpatient urology clinics at tertiary care medical centers in Korea participated. Gatifloxacin (400 mg/day) treatment (S.D.) of 149 patients (20 patients with category II and 129 patients with category IIIa) with prostatitis (mean age 45.8±13.3 years) was carried out for 41.7 (33.1) days. A 4-glass test according to Meares and Stamey or two glass test was carried out at study entry and one month after the end of treatment. Clinical response, safety and bacteriological response were assessed before treatment (within 48 hours of initiation of the study medication) and at one month after treatment completion. Results: In a otal of 149 patients, the total NIH-CPSI score was significantly reduced from 20.5 to 10.0 (response rate 86.7%; 95% CI 80.2-93.2%) (p<0.05). Sub-scores of pain, urinary symptoms and impact on the quality of life were also significantly reduced from 8.9 to 3.8 (response rate 83.8%; 95% CI 76.8-90.9%), from 4.2 to 2.0 (response rate 73.3%; 95% CI 64.9-81.8%) and from 7.4 to 4.2 (response rate 79.0%; 95% CI 71.3-86.8%), respectively (p<0.05). In terms of the overall clinical efficacy assessment by investigators, out of 149 patients with prostatitis, 71.2% were assessed to be responders. Bacteriological studies in expressed prostatic secretion (EPS) or post prostate massage urine (VB3) at 1 month after treatment completion demonstrated that the overall eradication rates of pathogens was 85% and the pyuria (≥10 WBC/HPF) rates in the NIH category II and IIIa were 35% and 18.6%, respectively (overall rate 20.8%). There were 16.1% of patients that presented with some adverse events considered by investigators to be related to the drug. The majority of adverse events were considered to be of mild (87.5%) or moderate (8.3%) intensity. Conclusions: These results suggest that gatifloxacin in Korean urologic practice is well tolerated and improves the clinical outcomes in the patientswith chronic prostatitis (NIH category II or IIIa)."

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Affecting Factors on the Treatment of Acute Pyelonephritis: Jae Min Chung, Seong Choi, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):73-77. Published online May 31, 2007

Abstract PDF: "Purpose: We analyzed the clinical aspects of acute pyelonephritis patients who received hospitalization treatment and the factors to effect a therapy session. Materials and Methods: We evaluated 108 patients with acute pyelonephritis who underwent hospitalization treatment between January 2003 and May 2006. The patients were divided into two groups by history taking, radiological and laboratory finding: group A consisted of 60 patients without co-morbid condition and group B consisted of 48 patients with co-morbid conditions. Comparisons of the two groups were made using independent t-tests with hospitalized durations, uropathogen types, clinical improvement durations, laboratory improvement durations and co-morbid conditions. Results: The analysis included 108 patients with a male to female sexual ratio of 1:7.3, a mean age of 51.3±16.8 years and a mean number of hospitalized days of 9.7±9.2 days. The co-morbid conditions were hypertension in 18 patients (16.7%), LUTS in 16 patients (14.8%), and diabetes mellitus in 15 patients (13.9%). The hospitalized durations of two groups were 7.4±3.3 and 10.5±6.2 days in group A and B. The uropathogen types were all E. coli in group A, whereas E. coli, Pseudomonas and Enterococcus were isolated in group B. Clinical and laboratory improvement duration of group A was significantly shorter than group B. The longer hospitalized duration of group B was seen in chronic renal failure and diabetes mellitus patients for 10.4±5.4 and 14.0±4.3 days and the longer laboratory improvement duration of group B was seen in chronic renal failure and diabetes mellitus patients for 5.3±5.2 and 5.9±5.5 days. Conclusions: We concluded that the acute pyelonephritis with co-morbidity conditions need longer hospitalized days than that without co-morbidity conditions. Two variable (diabetes mellitus, chronic renal failure) that predicted a poor response after therapy for acute uncomplicated pyelonephritis. The more variable uropathogen were identified in a urine culture with co-morbidity conditions."

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Granulomatous Prostatitis after Intravesical BCG Therapy: Sung Woo Park, Chang Yell Lee, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2007;2(1):92-95. Published online May 31, 2007

Abstract PDF: Granulomatous prostatitis is rarely reported pathologic condition after BCG instillation. But, it's real incidence might be much higher. The incidence, diagnosis, and treatment of these conditions are not confirmed. Herein, the case of granulomatous prostatitis, caused by intravesical BCG instillation is reported.

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Author Index