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Febrile Urinary Tract Infection in Infants: Comparative Analysis between Primary and Recurrent Infection
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Suk Gun Jung, Do Hoon Kong, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2011;6(2):186-191. Published online October 31, 2011
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 Abstract
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- "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
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Suk Gun Jung, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2011;6(1):67-72. Published online April 30, 2011
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Abstract
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- "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
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Suk Gun Jung, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2010;5(2):193-198. Published online October 31, 2010
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Abstract
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- "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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