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The Clinical Guidelines for Acute Uncomplicated Cystitis and Acute Uncomplicated Pyelonephritis
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Ki Ho Kim, Jae Heon Kim, Seung-Ju Lee, Hong Chung, Jae Min Chung, Jae Hung Jung, Hyun Sop Choe, Hun Choi, Sun-Ju Lee, The Committee of The Korean Association of Urogenital Track Infection and Inflammation
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Urogenit Tract Infect 2017;12(2):55-64. Published online August 31, 2017
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 Abstract
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- To date, there has not been an establishment of guidelines for urinary tract infections, due to limited domestic data in Korea, unlike other North American and European countries. The clinical characteristics, etiology, and antimicrobial susceptibility of urinary tract infections vary from country to country. Moreover, despite the same disease, antibiotic necessary to treat it may vary from country to country. Therefore, it is necessary to establish a guideline that is relevant to a specific country. However, in Korea, domestic data have been limited, and thus, guidelines considering the epidemiological characteristics pertaining specifically to Korea do not exist. Herein, describe a guideline that was developed by the committee of The Korean Association of Urogenital Tract Infection and Inflammation, which covers only the uncomplicated urinary tract infections, as covering all parts in the first production is difficult.
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The Antibiotic Susceptibility of Escherichia coli from Community-Acquired Uncomplicated Urinary Tract Infection: A Focused on Fosfomycin
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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
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Urogenit Tract Infect 2017;12(2):77-81. Published online August 31, 2017
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Abstract
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- 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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2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis
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Ki Ho Kim, Seung-Ju Lee, Yong-Hyun Cho, Hyun-Sop Choe, Yong Gil Na, Jae Heon Kim, Hong Chung, Jae Min Chung, Jae Hung Jung, Hoon Choi, Sun-Ju Lee
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Urogenit Tract Infect 2017;12(1):3-6. Published online April 30, 2017
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Abstract
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- Acute uncomplicated cystitis is the most common urinary tract infection that mainly occurs in adult females, particularly sexually active young women and postmenopausal women. It is commonly observed in primary health care settings, including urology as well as obstetrics and gynecology; more than half of healthy adult women visit clinics and hospitals at least once in their lifetime due to acute uncomplicated cystitis. The most common bacterium causing this condition is Escherichia coli, followed by Staphylococcus saprophyticus, Klebsiella pneumoniae, Proteus mirabilis, and etc. Trimethoprim-sulfamethoxazole or fluoroquinolones have been used as an empirical antibiotic treatment. However, as fluoroquinolone-resistant organisms or extended spectrum beta-lactamase-producing organisms are becoming more prevalent worldwide, information on regional antibiotic resistance and guidelines on antibiotic use are becoming increasingly more desparate.
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2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Recurrent Urinary Tract Infection
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Seung-Ju Lee, Hyun-Sop Choe, Yong Gil Na, Ki Ho Kim, Jae Heon Kim, Hong Chung, Jae Min Chung, Jae Hung Jung, Hoon Choi, Sun-Ju Lee, Yong-Hyun Cho
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Urogenit Tract Infect 2017;12(1):7-14. Published online April 30, 2017
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Abstract
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- Recurrent infection after an acute urinary tract infection (UTI) episode is common in adult women. It is onerous to both the patient and the physician to treat frequent recurrent UTI. Every time when UTI recurs, patients experience lower urinary tract symptoms, fatigue, and limitation in everyday life, while the physician has difficulty in counseling patients with a disease entity whose pathophysiology is less known. Currently, prophylactic treatment for recurrent UTI is limited, is ineffective in most cases, and sometimes accompanies unexpected side effects. In this guideline, we aimed to establish feasible and effective recommendations for the treatment of recurrent UTI in healthy adult women.
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Changing Epidemiology of Extended Spectrum Beta-Lactamases Pathogen of Urinary Tract
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Taesoo Choi, Koo Han Yoo, Sun-Ju Lee
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Urogenit Tract Infect 2015;10(2):74-83. Published online October 31, 2015
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Abstract
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- This review covers the recent findings on extended spectrum beta-lactamases (ESBL) pathogens, focusing on the epidemiology of infection due to this pathogen. Use of ESBL is growing rapidly and widely. CTX-M-15 producing ESBL Escherichia coli is the most commonly encountered in clinical practice. In general, ESBL infections are represented by urinary tract infections, but they can also cause fatal infections involving the vascular system and central nervous system. Because E. coli is a common colonizer of normal intestine, increasing prevalence of ESBL-producing pathogens is particularly troublesome. In a situation where ESBLs are disseminated in the community, the ideal control of this multidrug-resistant pathogen will be challenging. Precise data on the prevalence and risk factors of ESBL-producing microorganism are still undetermined. More epidemiological studies are needed for the question to be answered. In order to maximize efficiency of treatment, information on the trend of increasing numbers of ESBLs is also needed on persistence of ESBLs in carriers as well as better understanding of how antibiotic treatment and other risk factors affect their persistence and further dissemination. The global emergence of multidrug-resistant ESBL pathogen has recently led to critical treatment problems. Early detection, adequate antibiotic therapy, and effective prevention are necessary for achievement of a safe community.
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The Development and Limitation of the Animal Cystitis Models
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Koo Han Yoo, Sun-Ju Lee
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Korean J Urogenit Tract Infect Inflamm 2008;3(1):5-9. Published online April 30, 2008
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Abstract
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- Animal model refers to a non-human animal with a disease or injury that is similar to a human condition. Animal model is classified as induced model, naturally occurring model and genetically mutant model using the animal such as rat, mouse, rabbit, cat and so on. In consideration of chemical cystitis related model, methods of development of animal model are noxious intravesical stimuli, noxious systemic stimuli, noxious environmental stimuli and naturally occurring bladder disease in cats. These cystitis models introduced to interstitial cystitis, painful bladder syndrome. And in consideration of bacterial cystitis related model, identification and characterization of uropathogenic E. coli is useful method. On the other hands, innoculation of uropathogenic E. coli into the mouse or rats possible method. But animal models are weak in surrounding environments and stimuli, so the results from those can be changed. There is a wide variation between drug responses in dog and parrots, because of species differences. And in aspect of animal welfare consideration, we must remember that healthy animals used as experimental subjects serve as a means to our study.
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Characterization of Uropathogenic Escherichia coli
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Koo Han Yoo, Jeong-Je Cho1, Sun-Ju Lee
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Korean J Urogenit Tract Infect Inflamm 2007;2(1):61-65. Published online May 31, 2007
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Abstract
- " Purpose: Infections of the urinary tract are common allover the world and occur in all ages and both sex. The organism most commonly isolated from all types of urinary tract infections is Escherichia coli. Materials and Methods: We analyzed E. coli from a woman with acute cystitis. Among the pathogenic determinants of the uropathogenic E. coli strains, the p-fimbriae have been known to be associated with upper urinary tract infections. Results: Type 1 fimbriae (fimH), P family fimbriae (papA), S family fimbriae (sfa), hemolysin (hylA) and cytotoxic necrotizing factor I (cnfI) contribute to virulence in the urinary tract. So, it is important to characterize E. coli in laboratory study. Conclusions: The authors have used tools to reveal characteristics of E. coli, such as polymerase chain reaction, hemagglutination, hemolysin assay. This study provides how to characterize E. coli strains."
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