PURPOSE: The incidence and severity of catheter associated bacteriuria might be dependent on the catheterized duration and route, although this has not been clearly established yet. We evaluated the severity of urinary tract infection according to the duration of the indwelling urethral catheter and the effect of antibiotic therapy in rabbits. MATERIALS AND METHODS: A total of 54 rabbits were divided into one control group and two experimental groups; antibiotic and no antibiotic group, which were subdivided according to catheterized period(1, 4, 7 and 14-day). We examined the urinalysis, urine culture, qualitative biofilm culture and scanning electro-microscopy of the urethral catheter. RESULTS: 1. In the urinalysis, pyuria developed significantly both in 4, 7, 14-day group of no-antibiotic and in 14-day of antibiotic group compared to the control group(p<0.05). In the no antibiotic 7-day group, pyuria developed significantly as compared to that of the antibiotic group(p<0.05). 2. In the urine culture, positive urine culture was increased significantly in 7, 14-day of no-antibiotic group and 14-day of antibiotic group compared to the control group(p<0.05). In the no antibiotic 7-day group, positive urine culture developed significantly as compared to the antibiotic group(p<0.05). 3. In the qualitative biofilm culture of the urethral catheter, positive culture developed significantly in the no antibiotic 7, 14-day group and the antibiotic 14-day group as compared to the control group(p<0.05). Positive biofilm culture was developed significantly in the no antibiotic 7, 14-day group as compared to the antibiotic group(p<0.05). 4. In scanning electro-microscopy, bacterial biofilm of the urethral catheter was similar to the qualitative biofilm culture, and increased with increasing duration of the catheterization. CONCLUSIONS: It is suggested that the early removal of the urethral catheter is important for the reduction of chance of urethral catheter associated urinary tract infection. In case of a long-term indwelling urethral catheter(more than 2 weeks), prevention of urinary tract infection was very difficult despite antibiotic administration.
Bacteriuria ; Biofilms ; Catheterization ; Catheters ; Incidence ; Pyuria ; Rabbits ; Urinalysis ; Urinary Catheters* ; Urinary Tract Infections* ; Urinary Tract*

Urinary tract infection (UTI) is common in patients with diabetes mellitus. Furthermore, UTI is more severe, more often caused by resistant pathogens, and produces worse outcomes in those with diabetes mellitus. Although some patients may have altered clinical signs, symptoms of UTI are similar in patients with or without diabetes mellitus. Treatment depends on severity of systemic symptoms, results of urine culture, and underlying diseases of patients. There are no definite indications to treat asymptomatic bacteriuria in patients with diabetes mellitus.
Bacteriuria ; Diabetes Complications ; Diabetes Mellitus ; Humans ; Pyuria ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Previously considered as nonpathogenic contaminants, coagulase-negative staphylococci (CoNS) are now a major cause of nosocomial infections as increased use of prosthetic devices, intravascular catheters, and other invasive technology in more immunosuppressed patients and urinary tract infections (UTI) due to CoNS have been reported. In present study, species frequency, antimicrobial susceptability and clinical characteristics of CoNS UTI were evaluated. METHOD: We performed species identification and antimicrobial susceptibility of 109 CoNS strains isolated from urine in Ewha Womans University hospital from January 1998 to December 2002 and analysed clinical characteristics of 57 cases with CoNS UTI cases, retrospectively. RESULTS: Among 13,336 strains isolated from urine, 109 strains were CoNS showing 0.8%. The most common species of CoNS from urine were S. epidermidis (49.5%) followed by S. haemolyticus (16.5%), S. saprophyticus (13.8%), S. auricularis (1.8%), S. simulans (0.9%) and unidentified CoNS represented 17.4%. The antimicrobial susceptibility showed high resistance to multiple drugs. Among CoNS, S. haemolyticus showed the highest resistance whereas S. saprophyticus showed the highest susceptibility to multiple drugs. The patients isolated S. saprophyticus were younger (mean age: 41 yrs) than those isolated other CoNS (mean age: 53 yrs) and more frequently female (9/14 vs 19/43). The hospitalized patients (74.4% vs 21.4%), bacteriuria more than 10 5 CFU/ml (83.7% vs 64.3%), indwelling catheter (34.9% vs 7.1%) and other risk factors (48.8% vs 35.7%) were more common in patients isolated other CoNS than those isolated S. saprophyticus and no significant differences were noted in pyuria (51.2% vs 57.1%). The symptomatic presentations were more common in patients isolated S. saprophyticus than those isolated other CoNS (71.4% vs 9.3%) and so were treatment (85.7% vs 44.2%). CONCLUSIONS: When CoNS other than S. saprophyticus isolated from urine in hospitalized patientes with risk factors, identification and antimicrobial susceptability test is necessary for proper management.
Bacteriuria ; Catheters ; Catheters, Indwelling ; Cross Infection ; Female ; Humans ; Pyuria ; Retrospective Studies ; Risk Factors ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: This study was to verify the effects of a fluid therapy education program for aged stroke patients for preventing dehydration, pyuria and bacteriuria. METHODS: The study employed a non-equivalent control group pretest-posttest design in quasi experimental basis. Subjects were 38 stroke patients (20 in the experimental group and 18 in the control group) older than 65, hospitalized in a senior care center in S city, Korea. RESULTS: The amount of daily average fluid intake, normal ratio of blood urea nitrogen-creatinine ratio, serum Na+ and urine white blood cells were increased significantly in the experimental group. Normal ratio of bacteriuria increased in the experimental group, but not significantly. CONCLUSION: The education program is considered to be an effective nursing intervention tool for preventing dehydration and urinary tract infections which related to the secondary wellness of aged stroke patients. However, longer term study is necessary for better quality of nursing and developing more specific education programs for aged stroke patients usually hospitalized for a long period of time.
Bacteriuria ; Dehydration ; Education* ; Fluid Therapy* ; Humans ; Korea ; Leukocytes ; Nursing ; Pyuria ; Stroke* ; Urea ; Urinary Tract Infections

To evaluate the features of pyuria related to the bacteriuria, 140subjects were studied from Jan. 1987 to Dec. 1987. They pyuria was frequently developed from the age 30 to 60 years old, and male to female ratio was 1:1.41. The most common disease was urethrocystitis that was shown 42.8%. Common precipitating factors were urethral catheterization (25%) and urinary tract obstruction (11.4%). Through the observation, symptomatic pyuric patients were 66 subjects (47.1%), and the subjects with significant urine culture were 121 subjects (86.4%). In the urine culture, the most common bacteria was E. coli (41.4%), and the next was Pseudomonas (19.3%). A large percentage of E. coli and Pseudomonas was susceptible of amikin. The pyuria due to S. epidermidis and Accinatobacter was well treated. High therapeutic rate was observed in the acute pyelonephritis (71%) and urethrocystitis (67%). In the persistent urinary tract infection, there were relapsing (22 cases) and recurrent urinary tract infection (16 cases).
Amikacin ; Bacteria ; Bacteriuria ; Clinical Study* ; Female ; Humans ; Male ; Precipitating Factors ; Pseudomonas ; Pyelonephritis ; Pyuria* ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections

One thousand one hundred forty nine (1149) young women, 13-21 years of age, were examined by urinalysis and bacteriologic methods for the frequency and natural course of asymptomatic bacteriuria. Five percent (58/1149) of the women were found to have a significant bacteriuria, of which 58.6% (34/58) had a transient colonization in the urinary tract and another 41.4 % had a persistent bacteriuria. 66.7% (16/24) of recurrent bacteriuric subjects had gram negative rod bacilli. In 8.6%(5/58) of asymptomatic bacteriuric subjects, symptomatic urinary tract infection developed within 6 months. An incidence of pyuria in asymptomatic urinary tract infection is 80%, but a sensitivity of pyuria to bacteriuria was low in asymptomatic urinary tract infection. A predictive value for detection of asymptomatic bacteriuria by pyuria was 19%. With urine collection by urethral catheterization a chance of contamination can be diminished, but may not be eliminated a chance of contamination from urethral mucosa. Randomized double blind study showed that asymptomatic bacteriuria can be effectively controlled by daily single dose of trimethoprim sufamethoxazole for five days.
Bacteriuria* ; Colon ; Double-Blind Method ; Female ; Humans ; Incidence ; Mucous Membrane ; Pyuria ; Trimethoprim ; Urinalysis ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Urine Specimen Collection

This present study was performed to evaluate the clinical usefulness of the NBT test and to take the information of self defense mechanism of neutrophil in 40 cases with normal group and 110 cases with various infection groups in urology, such as acute pyelonephritis, chronic pyelonephritis, neurogenic bladder with chronic pyuria and chronic prostatitis. The results were as followings: 1. In normal group, the mean +/- 2 S.D. of WBC/mm3 was 5,725 +/- 1,164, neutrophils/mm3 3,202 +/- 929 and % of NBT positive neutrophils 8.14 +/- 3. 99. 2. Infection group; In acute pyelonephritis, the mean +/- 2 S.D. of WBC/mm3 was 10, 110 +/- 3,155, neutrophil/mma 7,281 +/- 1,469 and % of NBT positive neutrophils 13.14 +/- 5.09. In chronic pyelonephritis, the mean +/- 2 S.D. of WBC/mm3 was 6.053 +/- 2,976, neutrophils/mm3 3,495 +/- 1,642 and % of NBT positive neutrophils 8.66 +/- 3.26. In neurogenic bladder with chronic pyuria, the mean +/- 2 S.D. of WEC/mm3 was 6,503 +/- 2,003, neutrophils/mm3 3,735 +/- 1,049 and % of NBT positive neutrophils 5.83 +/- 4.72. In chronic prostatitis, the mean +/- 2 S.D. of WEC/mm3 was 6,096 +/- 2,771, neutrophils/mm3 3,524 +/- 1,977 and % of NBT positive neutrophils 6.82 +/- 5.54. 3. WBC, neutrophils/mm3 and % of NBT positive neutrophils were significantly increased in acute pyelonephritis. 4. WBC, neutrophils/mm3 and % of NBT positive neutrophils were not significant in chronic pyelonephritis. 5. WBC, neutrophils/mm3 were not significant, but % of NBT positive neutrophils was significantly decreased in neurogenic bladder with chronic pyuria and chronic prostatitis. 6. Authors can conclude that the function of self defense mechanism of neutrophils enhanced in acute stage of infection, but weakened as infection continues.
Neutrophils ; Prostatitis ; Pyelonephritis ; Pyuria ; Urinary Bladder, Neurogenic ; Urinary Tract Infections* ; Urinary Tract* ; Urology

BACKGROUND: In patients with chronic renal failure, infection is caused by altered host defense mechanism, and contributes significantly to their morbidities and mortalities. Especially, urinary tract infection often occurs in patients with chronic renal failure and is due to azotemia, infrequent voiding, low urinary flow rate and urinary concentration defects. This study was designed to compare the incidence of asymptomatic bacteriuria with chronic renal failure with that of normal control group. We also investigated whether risk factors for urinary tract infections in patients with chronic renal failure are similar to those in normal control groups. METHODS: 34 patients (M : F=13 : 21) with chronic renal failure and 30 normal control groups (M : F= 11 : 19) were evaluated in the Pusan National University Hospital from January 2001 through December 2001. Etiology of chronic renal failure included diabetes mellitus (n=16, 47.1%), hypertension (n=14, 41.2%) and glomerular diseases (n=4, 11.7%). 25 patients were treated with hemodialysis and 5 patients were treated with peritoneal dialysis. Others (n=4) were not treated with dialysis. Clean-catch, first voided urine was collected in the morning and examined by routine urinalysis and urine culture. RESULTS: 7 of 34 (20.6%) patients with chronic renal failure were positive in urine cultures and only one of 30 (3.3%) from the normal control group were positive. E. coli (n=2), Acinetobacter baumanii (n=2), Enterococcus spp. (n=2), S. aureus (n=1), P. aeruginosa (n=1), S. epidermidis (n=1) and Str. viridans (n=1) are cultured from urine specimens. There was a significant difference between the incidence of asymptomatic bacteriuria in patients with chronic renal failure and that of normal control group. But there was no significant difference in the presence of bacteriuria according to sex, age, etiology of renal failure, dialysis modality and pyuria. CONCLUSION: Patients with chronic renal failure have higher frequency of asymptomatic bacteriuria and pyuria than healthy subjects and tend to lead to symptomatic urinary tract infections.
Acinetobacter ; Azotemia ; Bacteriuria* ; Busan ; Diabetes Mellitus ; Dialysis ; Enterococcus ; Humans ; Hypertension ; Incidence ; Kidney Failure, Chronic* ; Mortality ; Peritoneal Dialysis ; Pyuria ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Urinalysis ; Urinary Tract Infections

Three hundred and ninety patients with benign prostatic hyperplasia managed at Seoul National University Hospital during a 5 year period from 1981 to 1985 were analyzed retrospectively. Most patients experienced urinary retention(60.3%) or had significant residual urine(l2.O %). Azotemia was found in 41 patients(10.5%) and bacteriuria in 67 patients(l7.2%). Intravenous pyelography was performed routinely in most of patients but it did not contribute significantly for the management. 217 transurethral(55.6%), 124 suprapubic(31.8%), and retropubic resections(12.6%) were done according to size of prostate, patient`s general condition and surgeon`s preference by 27 operators including 20 senior residents. The mean weight of resected tissue was 14.5gm in TUR and 36.1gm in open resection. The mean perioperative transfusion was l.2 pints in TUR and 2.2 pints in open resection. Overall morbidity of prostatectomy was l7.4% and there was no difference between TUR and open resection. Excessive bleeding was the major complication which developed in 6.9% of TUR and 6.4% of open resection. Initial azotemia, bacteriuria and old age over 80 years did not increase the operative morbidity. In TUR, 30gm or more of resceted adenoma and/or 90min or more of resection time increased the morbidity significantly. Prophylactic antibiotics decreased the postoperative urinary tract infection. The antibiotics were continued until 5~7 days after removal of catheter, and an additional antibiotics were not necessary even in the presence of microscopic pyuria which persistence for longer time. In 351 patients(90.9%), voiding problem was improved but in 39 patients(10%), it was persisted. Uroflowmetry was useful to evaluated the outcome of the resection. Maximum improvement in the flowrate was found 3 month postoperatively and the result was same in the patients with TUR and open resection.
Adenoma ; Anti-Bacterial Agents ; Azotemia ; Bacteriuria ; Catheters ; Hemorrhage ; Humans ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Pyuria ; Retrospective Studies ; Seoul ; Urinary Tract Infections ; Urography

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 Korea would be necessary.
Anti-Bacterial Agents ; Bacteriuria ; Child* ; Circumcision, Male ; Diagnosis ; Female ; Humans ; Infant ; Kidney ; Korea* ; Male ; Mass Screening ; Pyuria ; Surveys and Questionnaires ; Radionuclide Imaging ; Siblings ; Succimer ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux