• Title/Summary/Keyword: 요로감염

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요로감염과 방광요관역류

  • Kim, Gwang-Myeong
    • 학교보건
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    • s.25
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    • pp.50-53
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    • 2004
  • 소아 요로감염이 있을시 방광요관역류가 흔히 관찰되며 만성 신우 신염과 방광요관역류와 깊은 관계가 있는 것이 알려져 있다. 발열을 동반하는 소아 요로감염시 D MSA 신주사에서 급성 신우신염의 뚜렷한 소견이 있더라도 방광요관역류가 발견되지 않는 경우가 더 많다. 하지만 신장에 신 반흔이 있을 경우에는 흔히 방광요관역류가 관찰 된다. 소아 요로감염의 처치는 신 반흔의 형성을 막는데 그 궁극적 목적이 있다 하겠다. 신생아시기 심한 방광요관역류에서 요로감염이 없이 신 이형성증으로 인한 신 반흔이 관찰되기도 한다.

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Diabetes Story III - 당뇨병과 관련된 감염증 - 요로감염 -

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.220
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    • pp.36-38
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    • 2008
  • 요로감염은 우리에게 조금은 생소하지만 당뇨병으로 인한 감염으로 무시할 수 없는 부분을 차지한다. 당뇨로 인한 방광염의 빈도가 증가하면서 요로감염이 동반될 수도 있기 때문에, 그 심각성과 대처방안 등을 울산대학교병원 감염내과 전재범 교수에게 들어 보았다.

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Incidence of Febrile Urinary Tract Infection According to Clinical Characteristics in Patients with Congenital Hydronephrosis and Hydronephrotic Patients Diagnosed at First Febrile Urinary Tract Infection (선천성 수신증 환자군과 첫 발열성 요로감염으로 진단 시 발견된 수신증 환자군에서 임상적 특징에 따른 발열성 요로감염의 발생률)

  • Kim, Geun-Jung;Rhie, Seon-Kyeong;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.184-194
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    • 2010
  • Purpose : The aim of this study was to evaluate the incidence of febrile urinary tract infection (UTI) according to clinical characteristics in patients with congenital hydronephrosis (CH) and hydronephrotic patients first diagnosed with hydronephrosis during treatment of febrile UTII. Methods : In this study, 200 patients with congenital hydronephrosis were enrolled in group 1 and 252 patients first diagnosed with hydronephrosis during treatment of febrile UTI were enrolled in group 2. We counted the episodes of UTI in the two groups according to clinical characteristics, the presence of VUR, type of feeding, and clinical outcomes since 2000. And we compared those results between the two groups. and compared two groups as well. Results : The incidence of recurrent UTI was 10%, 0.028 per person-year in group 1 and 16.7%, 0.051 per person-year in group 2, respectively (P <0.05). Group 2 had more VUR (3% vs. 27%, P <0.05) and higher incidence of UTI than group 1. The incidence of UTI in patients with CH of Society of Fetal Urology (SFU) grade 4 or grade 4-5 VUR was 80% and 44.4%, respectively. No significant differences were found in incidence of UTI between BMF (breast milk feeding) and artificial milk feeding group in both groups (P 1=0.274, P 2=0.4). The time of resolution of CH had no correlation with either number of UTI episodes or the presence of VUR. Conclusion : The overall incidence of UTI is low in patients with CH as well as patients patients first diagnosed with hydronephrosis during treatment of febrile UTI except patients with SFU grade 4 or grade 4-5 VUR. BMF has no protective effect against UTI.

Treatment for Urinary Tract Infection of Children in Korea (우리나라 어린이 요로 감염의 치료 행태)

  • Kang, Hee-Gyung;Kim, Kwang-Myung;Cheong, Hae-Il;Choi, Hwang;Choi, Yong
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.15-21
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    • 2001
  • Purpose : Urinary tract infections (UTIs) of children require prompt and correct diagnosis and treatment to reduce the risk of renal damage. As a first step to improve the outcome of UTI in Korea, we investigated the practical variations in the methods of diagnosis, treatment, and evaluation of children with UTI and UTI prevention. Method :A questionnaire related to the individual policy on UTI diagnosis. treatment, imaging test, and prevention was submitted to 26 experts. Result Majority of the experts used bag-collected urine specimen for infants and mid-stream urine specimen for children for urinary culture. With a negative result of culture study, they diagnosed UTI when there was pyuria, positive results of the nitrite test, or bacteriuria. 80 $\%$ of experts prescribed prophylactic antibiotics after upper tract UTI. Operative treatment of vesicoureteral reflux (VUR) was indicated for children older than one or two years old with high-grade VUR, refractory breakthrough infections, or recurrent UTIs. Most of them performed kidney ultrasonography on the diagnosis of UTI and more than half of them evaluated children treated of UTI with vesicocystourethrogram and/or DMSA scintigraphy. Majority did not recommend circumcision. Half of the experts were screening siblings of VUR patients. Conclusion : Considering the variations exposed through this study systematic guidelines for management of children with UTI in Korean would be necessary. (J. Korean Soc Pediatr Nephrol 5 : 15-21, 2001)

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Prevalence of Vesicoureteral Reflux According to the Timing of Voiding Cystourethrography in Infantile Urinary Tract Infection (영아 요로감염에서 배뇨방광요도조영술 시기에 따른 방광요관역류의 발생 빈도: 두 기관 비교 연구)

  • Oh, Yoon-Su;Choi, Min-Jeong;Park, Se-Jin;Lee, Jae-Seung;Shin, Jae-Il;Kim, Kee-Hyuck
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.163-171
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    • 2011
  • Purpose : To evaluate the prevalence of vesicoureteral reflux (VUR) according to the timing of voiding cystourethrography (VCUG) in infantile urinary tract infection (UTI). Methods : The data of 134 infants (1-12 months) with renal cortical defect in $^{99m}Tc$-2, 3-dimercaptosuccinic acid ($^{99m}Tc$-DMSA) scan with a diagnosis of UTI in two hospitals from 2000 to 2010 were retrospectively analyzed. The VCUG was performed after 2 weeks from the diagnosis of UTI in Group I (n=68), and the VCUG was performed within 2 weeks from the diagnosis of UTI in Group II (n=66). Results : There were no significant differences between the two groups in the duration of fever, white blood cell count, C-reactive protein levels, and abnormalities in ultrasonography (P>0.05). There was no significant difference between the two groups in the prevelence of VUR, bilateral VUR, and severe VUR. VCUG-induced UTI was detected 16 (23.5%) of patients in whom the procedure was performed 2 weeks after the diagnosis, and none of VCUG-induced UTI occurred in those in whom the procedure was performed 2 weeks within the diagnosis. Conclusion : We conclude that the prevalence of VUR according to the timing of VCUG did not differ between the two groups in infantile UTI with renal cortical defect in DMSA scan. We also found that performing VCUG with antibiotics can decrease risk of VCUG-induced UTI.

Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City (대구지역 소아청소년과 의사들의 요로감염 관리 실태분석)

  • Lee, Sang Su;Kang, Seok Jeong;Lee, Jae Min;Cho, Min Hyun;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.95-101
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    • 2012
  • Purpose: Recently, many evidence-based guidelines for the management of urinary tract infection (UTI) have been developed because of the importance of proper management. However, there is a lack of data regarding how pediatricians manage UTIs in Korea. Therefore, we surveyed pediatricians to determine whether they manage UTIs in an appropriate manner. Methods: A postal questionnaire survey of 78 pediatricians practicing in Daegu city was performed. Subjects were asked about diagnosis, imaging studies, treatment, and prevention of UTIs. Results: Most of the respondents (94.8%) performed urinalysis to diagnose UTI in febrile children with an unknown fever focus. However, many preferred inaccurate collection methods, such as bagged urine collection, and did not obtain urine cultures. The most frequently performed imaging modality was renal-bladder ultrasonogram. Orally administered antibiotics were preferred unless admission was needed. After diagnosis of UTI, the pediatricians usually provided information to caregivers about the disease itself and supplementary treatment. Of the respondents, only 28.6% had their own guidelines for management of vesicoureteral reflux. Conclusion: Most pediatricians suspected UTI in febrile children with an unknown focus appropriately. Nevertheless, the fact that many pediatricians preferred inaccurate urine collection methods and did not perform sufficient imaging studies to detect associated abnormalities likely resulted in overtreatment due to false-positive diagnosis of UTI and a low probability of ruling out genitourinary anatomical problems. To improve the quality of management of UTI, pediatricians should follow scientific and evidence-based guidelines.

Significance of Random Urine ${\beta}_2$-Microglobulin as a Marker for Vesico-ureteral Reflux in Children with Urinary Tract Infection (요로감염 환자에서 방광요관역류의 지표로서 무작위 추출뇨중 ${\beta}_2$-microglobulin의 의의)

  • Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.72-79
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    • 1999
  • Renal scarring associated with vesico-ureteral reflux(VUR) is one of the major causes of end stage renal failure and renal hypertension in children. Urinary ${\beta}_2$-microglobulin(MG) has been suggested as a potential marker for presence of renal tubular damage. This study was designed to evaluate the significance of random urine ${\beta}_2$-MG as a predictor of presence of vesico-ureteral reflux in children with urinary tract infection(UTI). 57 children with urinary tract infection were studied. Patients were devided into two groups; 35($78.9\%$) children have UTI without VUR and 12($21.1\%$) children have UTI and VUR. Beta2-MG and creatinine in random urine sample was measured to decide the excretion ratio(${\beta}_2$-MG/creatinine). Among the 57 children with UTI, 44 children were confirmed by urine culture study and 13 children suspected by compatible clinical feature. Random urine ${\beta}_2$-MG of VUR group ($2.2{\pm}5.91$ mg/L) were significantly higher than that of simple UTI group($0.19{\pm}0.16mg/L$)(P=0.03). The ${\beta}_2$-MG/creatinine ratio of VUR group($32.41{\pm}25.7$) were significantly higher than that of simple UTI group($3.93{\pm}3.44$)(P=0.007). In conclusion, random urine ${\beta}_2$-MG and excretion ratio deserved early predictor of presence of VUR in children with UTI. And this method was more simple and inexpensive than the method of measuring ${\beta}_2$-MG with 24 hour urine collection, so might be a useful screening test for VUR in children with UTI.

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Incidence and Risk Factors of Recurrent Urinary Tract Infections during Antibiotic Prophylaxis in Children with Primary Vesicoureteral Reflux (일차성 방광요관역류 소아에서 항생제 예방요법 중에 발생한 재발성 요로감염의 빈도와 위험인자)

  • Cho Su-Jin;Kim, Hyun-Jin;Lee Jeong-Won;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.46-55
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    • 2005
  • Purpose : Recurrent urinary tract Infection(UTI) in primary vesicoureteral reflux(VUR) may lead to serious renal scarring, a major cause of childhood hypertension and end-stage renal disease. To prevent recurrent UTI, low-dose long--term antibiotic prophylaxis has been recommended. However, recurrent UTI still develops during antibiotic prophylaxis, the efficacy of which is now being disputed. The emergence of resistant bacteria has also raised concerns. To evaluate the effect of antibiotic prophylaxis, we investigated recurrent UTI during prophylactic antibiotic use in children with primary VUR Materials : The incidence and risk factors of recurrent UTI were retrospectively evaluated in ninety-one children with primary VUR on trimethoprim- sulfamethoxazole(TMP/SMX) prophylafis during the year following their index febri]e UTI. Results : Recurrent UTI occurred in 31.9%(29/91) children and comprised 0.32 episodes/patient year. Febrile UTI was 0.26 episode/patient year and afebrile UTI was 0.07 episodes/patient year. The recurrent rate of UTI in male patients with phimosis was 37.2%(19/51), which was significantly higher than in males without phimosis 0%(0/5)(P=0.025). In the logistic regression analysis for recurrent UTI, renal scar was the significant risk factor for recurrent UTI [RR 3.8(95% CI 1.0-14.1) P=0.04]. For other well-known risk factors such as sex, age, degree of VUR, APN, and voiding dysfunction, the differences were not significant. Conclusion : TMP/SMX prophylaxis did not prevent recurrent UTI in children with primary VUR. Phimosis and renal scars were the risk factors for recurrent UTI but the grade of primary VUR was not. In VUR without phlmosis and renal scar, a randomized controlled study without antibiotic prophylaxis is required. (J Korean Soc Pediatr Nephrol 2005;9:46-55)

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특집_당뇨병환자의 감염증 - 당뇨병환자에게 흔한 '요로 감염증'

  • Tak, U-Taek
    • The Monthly Diabetes
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    • s.240
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    • pp.17-19
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    • 2009
  • 요로 감염증은 당뇨병환자에게 흔히 발생하는 대표적인 감염질환 중 하나이다. 당뇨병환자에서 감염이 흔한 이유는 여러 가설들이 있으나, 다양한 기전에 의한 면역체계의 이상과 면역 저하 등 때문으로 생각하고 있다. 당뇨병환자에서 일반적인 감염이 좀 더 빈번하게 일어나지만 거의 당뇨병에서만 관찰되는 희귀 감염질환도 흔한데 그 중 요로의 기종성(공기주머니 형성) 염증은 특징적이다. 또한 일반 요로 감염에서는 흔하지 않은 칸디다와 같은 진균(곰팡이균)에 의한 요로 감염도 드물지 않게 관찰할 수 있다. 따라서 여기에서는 당뇨병에서 보이는 요로 감염의 특징과 대처방법에 대해서 살펴보기로 한다.

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Changes in Causative Organisms and Antimicrobial Susceptibility of the Urinary Tract Infection (요로감염의 주요 원인균과 항생제 감수성의 변화에 관한 고찰)

  • Ha, Tae Uk;Hwang, Yong;Park, Seung Chol;Lee, Jea Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.85-93
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    • 2017
  • The urinary tract infection (UTI) is one of the most important infections in hospital. The overuse and misuse of antimicrobial agents and the resulting emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. This study examined the changes in the antibiotic susceptibility to the causative organisms of urinary tract infections to provide useful information on the choice of adequate drugs in the treatment of urinary tract infections. The medical records of 2,707 patients with more than $10^5/ml$ microorganism in urine culture between January 2010 and December 2015 were reviewed retrospectively. The most common pathogenic organism was E. coli (28.1%). In the case of E.coli, there were no differences in frequency from 2010 to 2015 in men, but since 2014, the frequency decreased gradually since 2014 in women. For E. coli, the resistance rates to antibiotics were 72.2% in ampicillin, 44.9% in trimethoprim/sulfamethoxazole (TMP/SMX), and 41.3% in ciprofloxacin, but the 2nd, 3rd, and 4th cephalosporin (5%) had low antibiotic resistance rates. The pathogens of urinary tract infection are becoming diverse and their frequencies are also changing over time. These results suggest that the recommended drugs for UTI should be selected more carefully for in-patients and out-patients.