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Urogenit Tract Infect : Urogenital Tract Infection

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Sang Jin Kim 2 Articles
Management of Candida Urinary Tract Infection in the Elderly
Sang Jin Kim, Jae Hyun Ryu, Yun Beom Kim, Seung Ok Yang
Urogenit Tract Infect 2019;14(2):33-41.   Published online August 30, 2019
DOI: https://doi.org/10.14777/uti.2019.14.2.33
AbstractAbstract PDF
Candida urinary tract infections in elderly patients are becoming increasingly common. The risk factors for the development of candiduria include old age, use of broad-spectrum antibiotics, corticosteroids and indwelling urethral catheters, as well as diabetes mellitus, urological abnormalities, and hematological malignancies. The presence of signs and symptoms of infection are unusual, and the intensity of fungal growth in culture does not correlate with the outcome. Elderly patients often present with atypical signs and symptoms of infection. Careful assessment of the patient’s clinical status should be undertaken before treatment is initiated. The indications for antifungal therapy are the same for older and younger individuals, and the initial antifungal therapy should be selected based on the infecting organism and local epidemiology. Fluconazole is the mainstay of treatment. On the other hand, Candida glabrata is more common in elderly patients and is often refractory to fluconazole therapy. The selection of drug therapy for elderly patients should consider the comorbidities, risk of drug-drug interactions, and dose adjustment for physiological function.
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Clinical Data of Urine Culture and Antimicrobial Sensitivity Tests according to the Voiding Method over 15 Years in Patients with Spinal Cord Injury
Won Jun Lee, Sang Jin Kim, Jae Hyun Ryu, Yun Beom Kim, Seung Ok Yang, Jeong Ki Lee, Tae Young Jung
Urogenit Tract Infect 2016;11(1):30-35.   Published online April 30, 2016
AbstractAbstract PDF
Purpose: To analyze the results of urine cultures and antimicrobial sensitivity tests according to the voiding methods in patients with spinal cord injury (SCI) over a 15-year period.
Materials and Methods: A total of 1,579 urine culture samples, obtained from January 2000 to December 2014, for 73 SCI patients were analyzed according to the voiding method. We analyzed the following: positive urine culture rate, colony counts, isolated number of organism, major organisms, and antimicrobial sensitivity tests. The voiding methods were categorized into four methods: clean intermittent catheterization (CIC), suprapubic catheterization (SPC), urethral Foley catheter, and spontaneous voiding (SV).
Results: Among the 1,579 urine samples, 1,250 (79.2%) were positive. The CIC group showed the lowest rate of bacteriuria (p<0.001), colony counts (p<0.001), and polymicrobial infection (p<0.001). Causative organisms were mostly gram-negative bacteria (86.7%). Pseudomonas aeruginosa (22.7%) was most common pathogen followed by Escherichia coli (22.3%), Klebsiella species (9.5%), Providencia species (4.4%), and Serratia marcescens (4.2%). Major pathogens and antimicrobial sensitivity tests were different according to the voiding method.
Conclusions: CIC is the best voiding method to reduce urinary tract infection (UTI) in SCI patients. To treat UTI in in SCI patients, empirical antibiotics can be chosen according to the voiding method based on the reference of our study prior to the availability of antimicrobial sensitivity results.
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