OBJECTIVE: To examine the ability of an antimicrobial agent Ciprofloxacin to diffuse through a Foley catheter retention balloon.
METHODS: The Utraviolet-Visible (UV-Vis) Spectophotometer (UV-1700 PharmaSpec) was utilized to detect the diffusion of the analyte (Ciprofloxacin) through end parameters such as peak absorbance and corresponding wavelengths.
RESULTS: On UV-Vis spectophotometer, the control sample of sterile water was analyzed and found to have the lowest peak absorbance value of only 0.003 at a wavelength of 343 nm. The peak absorbance values of subsequent samples, taken from the same environment (sterile water), since submersion of the catheter balloon, on day-3, day-8, day-15 had increasing peak absorbance values on their corresponding wavelengths.
CONCLUSIONS: In this study, the samples of sterile water from the outside environment of the submerged catheter yielded progressively increasing peak absorbance values on the succeeding days of submersion. Thereby, In lieu of this principle, one can infr the diffusion of the analyte throgh the catheter membrane, as reflected by the summary of peak absorbance value.

Effect of Enoxacin (Flumark), an oral pyridone carboxylic acid, in the urinary tract infection was evaluated clinically and susceptibility of 292 strains of microorganism isolated from urine to the various antimicrobial agents was tested and compared. Thirty six patients with urinary tract infection were given with 300 to 600mg of Enoxacin daily for 7 to 14 days according to severity of urinary tract infection. The clinical symptoms and urinary findings improved in 30 patients (83.3%) and no clinical response was achieved in 6 patients (16.7%), but revealing 100% response in 9 patients of acute uncomplicated cystitis. In the antimicrobial susceptibility test, Enoxacin was much superior to aminoglycoside, especially against Pseudomonas aeruginosa. Serratia spp., Enterobacter spp. and other Pseudomonas spp.. Enoxacin is a very effective and safe antimicrobial agent in treatment of the urinary tract infection.
Anti-Infective Agents ; Cystitis ; Enoxacin ; Enterobacter ; Humans ; Pseudomonas ; Pseudomonas aeruginosa ; Serratia ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Myroides species are widely distributed in nature, but clinical infection by these organisms are extremely rare. We report herein prolonged outbreak of urinary tract infection by Myroides species. METHODS: Forty-four Myroides spp. were isolated from urine samples from 25 patients over a period of nine months, and random amplified polymorphic DNA (RAPD) method was performed to characterize the genotype of these isolates. RESULTS: All of the subjects were hospitalized patients with indwelling urinary catheter. Five of the patients showed concomitant pyuria, which could be considered as evidence of urinary tract infection, and isolation of these organisms in the remainder of the patients could be considered as simple colonization. All the isolates were resistant to antimicrobial agents tested. RAPD analysis showed identical DNA fingerprinting patterns in all the isolates. CONCLUSION: This study revealed that all the Myroides spp. isolated from urinary specimens of prolonged outbreak were genotypically the same. Because of its resistance to multiple antimicrobial agents, prevention of dissemination of this strain is clinically important.
Anti-Infective Agents ; Colon ; DNA ; DNA Fingerprinting ; Epidemiologic Studies* ; Genotype ; Humans ; Pyuria ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Myroides species are widely distributed in nature, but clinical infection by these organisms are extremely rare. We report herein prolonged outbreak of urinary tract infection by Myroides species. METHODS: Forty-four Myroides spp. were isolated from urine samples from 25 patients over a period of nine months, and random amplified polymorphic DNA (RAPD) method was performed to characterize the genotype of these isolates. RESULTS: All of the subjects were hospitalized patients with indwelling urinary catheter. Five of the patients showed concomitant pyuria, which could be considered as evidence of urinary tract infection, and isolation of these organisms in the remainder of the patients could be considered as simple colonization. All the isolates were resistant to antimicrobial agents tested. RAPD analysis showed identical DNA fingerprinting patterns in all the isolates. CONCLUSION: This study revealed that all the Myroides spp. isolated from urinary specimens of prolonged outbreak were genotypically the same. Because of its resistance to multiple antimicrobial agents, prevention of dissemination of this strain is clinically important.
Anti-Infective Agents ; Colon ; DNA ; DNA Fingerprinting ; Epidemiologic Studies* ; Genotype ; Humans ; Pyuria ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

Therapy with appropriate antimicrobial agents is an important component in the management of patients with liver, biliary and pancreatic infection. Acute cholangitis and cholecystitis are common conditions that may result in progressively severe infection. Infectious complications, both pancreatic (infected necrosis) and extrapancreatic (pneumonia, cholangitis, bacteremia, urinary tract infections, and so on), are a major cause of morbidity and mortality in patients with acute pancreatitis. Antimicrobial agents appropriate for initial therapy (empirical therapy or presumptive therapy) for various grades of severity of infections should be used. Local antimicrobial susceptibility patterns should be considered for use.
Anti-Bacterial Agents* ; Anti-Infective Agents ; Bacteremia ; Cholangitis ; Cholecystitis ; Cholecystitis, Acute ; Humans ; Liver ; Mortality ; Pancreatitis ; Urinary Tract Infections

Unusual morphology of aberrant forms of bacteria, presented with grotesque-giant form, 15 m 3 m, with central emptiness and fusiform ends was observed in urine Gram stain from a 26-year-old woman who was admitted with the symptoms of acute urinary tract infection. On wet smear, these bacilli were markedly swollen, yeast-like organisms. In addition to normal shaped bacilli, various shapes of another aberrant bacteria, such as long bacilli, filamentous form, filamentous form with central bulge, and bipolar staining with central emptiness were also observed in the same specimen. The morphologic characteristics of these unusual aberrant bacilli were more distinct on Papanicolaou stain than on Gram stain. In Korea, where antimicrobial agents are overused and disused, the frequency of observing the aberrant bacteria would be much higher than cases reported. Here we report unusual morphology of aberrant forms of Escherichia coli with the emphasis on awaring of the potential appearance of such bacilli in clinical specimen and avoiding confusion with fungi and other naturally filamentous organisms.
Adult ; Anti-Infective Agents ; Bacteria* ; Escherichia coli ; Female ; Fungi ; Humans ; Korea ; Urinary Tract Infections

PURPOSE: Pseudomonas aeruginosa is an important pathogen in complicated urinary tract infections(UTIs). The aim of this study was to evaluate the isolation rate of Pseudomonas from patients with UTIs and to define the accompanying clinical features. MATERIALS AND METHODS: Between January 2000 and December 2006, we retrospectively reviewed the medical records of 170 urology patients with Pseudomonas UTIs. We analyzed the isolation rate of Pseudomonas in patients with UTIs and determined the antibiotic susceptibilities. We also analyzed the clinical features and underlying diseases in patients with Pseudomonas UTIs. RESULTS: Pseudomonas was cultured in the urine from 234 of 3,470 patients (6.6%) with positive urine cultures. One hundred seventy of 234 patients had underlying urologic disease. Eighty-two patients(48.2%) had indwelling urinary catheters and 34 patients(20.0%) had diabetes. Patients with catheters tended to have febrile UTIs compared to patients without catheters(70.7% vs. 42.0%, respectively). The isolation rate of Pseudomonas increased between 2000 and 2006(2.8% vs. 13.1%, respectively). The sensitivity of Pseudomonas to most antibiotics decreased between 2000 and 2006. Patients with neurogenic disease and catheters were more easily infected with Pseudomonas. CONCLUSIONS: The isolation rate of Pseudomonas in urine cultures is on the rise. Patients with UTIs and catheters, unlike those without, have high fevers. Because the sensitivity of Pseudomonas to antimicrobial agents has decreased, we need to choose appropriate antibiotics through urine cultures and antibiotics sensitivity tests in treating complicated UTIs.
Anti-Bacterial Agents ; Anti-Infective Agents ; Catheters ; Fever ; Humans ; Medical Records ; Pseudomonas ; Pseudomonas aeruginosa ; Retrospective Studies ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Urologic Diseases ; Urology

BACKGROUND: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult .Therefore,a new system that separated prescribing and dispensing medicine began on July 1,1997 to prevent overuse and misuse of medicine.We studied to evaluate changes of antibiotic sensitivities to causative microorganisms of urinary tract infection 2 years before and after the new medical system. METHODS: During each 2 years before and after the new medical system,we analyzed antibiotic sensitivities of causative microorganisms for urinary tract infection among the 447 out-patients who visited a hospital in GangNeung.The diagnosis of urinary tract infection was based on greater than 105 CFU (Colony For Unit)per ml.urine. RESULTS: The most common pathogenic microorganisms as E.coli (76.5%),followed by Klebsiella pneumoniae (5.1%),and Proteus mirabilis (3.6%)in urine culture. A first generation cephalosporin,cephalothin,against E.coli, had more significant sensitivity after the introduction of the new medical system (52.6%)than before (33.9%),especially in the 80th decade (P=0.023) and in females (P<0.001).Also,trimethoprim/sulfamethoxazole against E.coli showed signifcant improving sensitivity (P=0.025). CONCLUSION: There was little change of antibiotic sensitivity of urinary tract infection in out-patients before and after the new medical system in cephalothin and trimethoprim/sulfamethoxazole against E.coli. The change of antibiotic sensitivities will require further observation for a longer term after the introduction of the new medical system.
Anti-Infective Agents ; Cephalothin ; Diagnosis ; Female ; Humans ; Klebsiella pneumoniae ; Outpatients* ; Prescriptions* ; Proteus mirabilis ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: The antibiotic sensitivities to the causative microorganisms of urinary tract infection (UTI) during 2003 were studied in order to propose a better choice of adequate drugs for the treatment of UTI. MATERIALS AND METHODS: 1,527 uropathogens and their antimicrobial sensitivities, in 889 patients admitted to or visiting our hospital during 2003, which revealed isolated causative organisms in the urine cultures, were analyzed. RESULTS: The incidence of UTI was highest in the 7th decade. The Most common pathogenic organism was E. coli (46.4%), followed by Enterococcus (18.8%), Pseudomonas (7.1%), Klebsiella (5.7%) and Staphylococcus (4.5%). The antimicrobial sensitivities for gram-negative organisms, imipenem, aminoglycoside, ciprofloxacin showed relatively higher sensitivities than for TMP/SMX and ampicillin. In gram-positive organisms, vancomycin and aminoglycoside showed higher sensitivities than any of the other antimicrobial agents. Most of the antimicrobial agents had better sensitive rates in the outpatients. CONCLUSIONS: E. coli was the most common single organism causing UTI, and showed more resistance to the first recommended drugs, TMP/SMX and ampicillin. Our results imply that recommended the drugs for UTI should be aminoglycoside and ciprofloxacin for inpatients and outpatients, respectively. Aminoglycoside can be used as an alternative to these drugs as a primary empirical antimicrobial agents for UTI.
Ampicillin ; Anti-Bacterial Agents ; Anti-Infective Agents ; Ciprofloxacin ; Enterococcus ; Humans ; Imipenem ; Incidence ; Inpatients ; Klebsiella ; Outpatients ; Pseudomonas ; Staphylococcus ; Urinary Tract Infections* ; Urinary Tract* ; Vancomycin

PURPOSE: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. We studied the changes of antibiotic sensitivity to the causative organisms of urinary tract infection(UTI) for recent 5 years in order to give some useful informations about the choice of adequate drug in the treatment of UTI. MATERIALS AND METHODS: We analysed 1191 uropathogens and their antibiotic sensitivities of the 1132 patients who admitted or visited the National Police Hospital and had more than 105cfu/ml on urine culture from January 1994 to December 1998 retrospectively. RESULTS: The common pathogenic organisms were E. coli(51.5%), staphylococcus(15.7%), pseudomonas(9.1%), klebsiella(7.5%) and enterobacter(4.0%), enterococcus(3.4%), proteus(3.1%) in order. The incidence of E. coli decreased from 50.8% in 1994 to 41.3% in 1998 but the incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter increased from 24.8% in 1994 to 42.6% in 1998. In E. coli isolates(the majority of positive cultures), resistance to six antibiotics changed significantly: ampicillin(19.4% to 15.5%), piperacillin(44.1% to 32.0%), cephalothin(70.6% to 58.6%), gentamicin(62.8% to 60.2%), tobramycin(95.0% to 88.1%), and ciprofloxacin(87.6% to 76.3%). The sensitivity rates of the gram negative organisms including E. coli were very low in 1998 (ampicillin 11.6%, piperacillin 36.6%, and trimethoprim/sulfamethoxazole 49.3%). CONCLUSIONS: We think that E. coli is still the most important organism in the UTI but we shoud be concerned about the increasing incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter. And prior to receiving the bacteriological report, using ampicillin, trimethoprim/sulfamethoxazole as the first choice in the treatment of UTI shoud be reconsidered.
Acinetobacter ; Ampicillin ; Anti-Bacterial Agents ; Anti-Infective Agents ; Enterobacter ; Humans ; Incidence ; Klebsiella ; Piperacillin ; Police ; Proteus ; Pseudomonas ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*