No abstract available.
Bacteriuria*

PURPOSE: To evaluate the cause of asymptomatic bacteriuria (AB) or aseptic pyuria (AP) on physiologic phimosis and to evaluate the effect of topical steroid therapy and preputial hygiene on the resolution of AB and AP. METHODS: Ninety uncircumcised boys (age 1-72 month, median 16 month) with AB or AP were examined for physiologic phimosis and allocated by the preputial retractibility into the non-retractile group (n=59) or the retractile group (n=31). Topical steroid therapy [topical application of hydrocortisone (0.1%) cream with physiotherapy] were prescribed (three times a day) and the method of preputial hygiene (gentle retraction of prepuce and water cleansing) was instructed to the non- retractile group . After 2-4 weeks, the preputial retractibility was reevaluated and urine examination was repeated. To the retractile group, only the method of preputial hygiene was instructed and urine examination was repeated two weeks later. RESULTS: Among 90 boys with AB and AP, 65.6% (59/90) had the nonretractile prepuces and nonperformed preputial hygiene. In the nonretractile group, the prepuces became retractile in 81.4 % (48/59) after topical steroid therapy. Among boys (n=48) whose prepuces became retractile after topical steroid therapy, AB or AP resolved in 77.1%, decreased in 18.7% and persisted in 4.2%, which were significantly different to 18.2%, 2.37%, 54.5% in boys (n=11) whose prepuces were persistently nonretractile (P=0.0114). In the retractile group (n=31), 65.2% was compliant to preputial hygiene. In boys (n=23) who were compliant to preputial hygiene, AB or AP resolved in 65.2%, decreased in 26.0% and persisted in 8.2%, which were significantly different to 12.5%, 50%, 37.5% in boys (n=8) who were not compliant (P=0.0457). CONCLUSION: Physiologic phimosis was an important cause of AB or AP. Simple topical steroid therapy on the nonretractile prepuces and good preputial hygiene could improve AB or AP.
Bacteriuria ; Female ; Hydrocortisone ; Hygiene ; Phimosis ; Pyuria ; Water

Of acute scrotal lesions in the neonates, cases needing emergent exploration are quite rare and differential diagnosis of them is not easy. Only a few cases of inflamed hydroceles occurring in young boys have been reported to have been caused by bacterial infection in the literature. We couldn't find any case concerning simultaneous bacterial infection in urine and hydrocele by the same organisms. We present an unusual case of infected hydrocele in a neonate with bacteriuria.
Bacteriuria/*etiology ; Case Report ; Human ; Hydrocele/*etiology ; Infant, Newborn ; Male

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.
Bacteriuria ; Coloring Agents ; Cost Savings ; Leukocytes ; Mass Screening* ; Pyuria ; Urinalysis*

BACKGROUND: Rapid detection of bacteriuria is desirable for diagnosis and treatment of urinary tract infections. The aim of this study was to assess the usefulness of the cytocentrifuge Gram stain, uncentrifuged Gram stain, and urinary nitrite, leukocyte esterase to determine the exclusion of urine culture. METHODS: A cytocentrifuge Gram stain procedure and urine dipstick test were performed to screen for bacteriuria using 155 random fresh urine specimens submitted for routine culture. The authors compared the results of the cytocentrifuge Gram stain, urinary nitrite, leukocyte esterase and multiapplication of three tests with the results of culture. Result: Compared with positive urine culture(>105CFU/mL), cytocentrifuge Gram stain had a good negative predictive value(96.0%) and sensitivity(89.1%). The urinary nitrite and leukocyte esterase test had very low sensitivity(27.0%, 45.9%), respectively. The multiapplication of cytocentrifuge Gram stain, urinary nitrite and leukocyte esterase had a excellent negative predictive value(98.9%) and sensitivity(97.3%), and agree with urine culture positive(36/37 cases, 97.3%). CONCLUSION: Multiapplication of urinary cytocentrifuge Gram stain, nitrite and leukocyte esterase test is a useful screening test for the rapid exclusion of bacteriuria and provides rapid morphologic information about suspected pathogens in cases with positive urine culture.
Bacteriuria* ; Diagnosis ; Leukocytes ; Mass Screening* ; Urinary Tract Infections

BACKGROUND: Although bacteriologic culture remains the gold standard for detecting bactriuria, leukocyte esterase, nitrite and urine microscopy are also widely used. However, it is not uncommon to be presented with a discrepancy between these tests. METHODS: We performed leukocyte esterase and nitrite tests by urine reagent strip testing (Combur 10 Test, Roche, Germany), microscopic urinalysis, and by bacteriologic urine culture on 290 persons. RESULTS: The number of pathogens and non-pathogens were 51 (17.6%) and 87 (30.0%) respectively. The number of cases in which no microorganism was isolated (NMI group) was 152 (52.4%). The concordance rate between leukocyte esterase and microscopic leukocytes (leukocyturia) was 70.7%. The sensitivities and specificities of leukocyte esterase, microscopic leukocyte and microscopic bacteria were 72.5%/61.8%, 76.5%/44.1 % and 80.4%/92.1% respectively, and their positive predictive values and negative predictive values were 24% (62.3%)/69.1% (89.7%), 21.3% (53.6%)/62.6% (88.8%) and 51.9% (84.8%)/66.4% (95.3%), respectively. Although the nitrite test showed higher positive rates in the pathogen groups (37.2%) than in the non-pathogen group (2.2%) and NMI group (1.3%), this was only marginally significant. CONCLUSION: The microscopic estimation of bacteria is more a predictable marker of bacteriuria, rather than leukocyte esterase, nitrite, and microscopic leukocytes, in urine.
Bacteria ; Bacteriuria* ; Humans ; Leukocytes* ; Microscopy ; Reagent Strips ; Urinalysis

Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.
Pregnancy ; Urinary tract infection ; Asymptomatic bacteriuria ; Acute ; therapeutic aspects

BACKGROUND: Although bacteriologic culture remains the gold standard for detecting bactriuria, leukocyte esterase, nitrite and urine microscopy are also widely used. However, it is not uncommon to be presented with a discrepancy between these tests. METHODS: We performed leukocyte esterase and nitrite tests by urine reagent strip testing (Combur 10 Test, Roche, Germany), microscopic urinalysis, and by bacteriologic urine culture on 290 persons. RESULTS: The number of pathogens and non-pathogens were 51 (17.6%) and 87 (30.0%) respectively. The number of cases in which no microorganism was isolated (NMI group) was 152 (52.4%). The concordance rate between leukocyte esterase and microscopic leukocytes (leukocyturia) was 70.7%. The sensitivities and specificities of leukocyte esterase, microscopic leukocyte and microscopic bacteria were 72.5%/61.8%, 76.5%/44.1 % and 80.4%/92.1% respectively, and their positive predictive values and negative predictive values were 24% (62.3%)/69.1% (89.7%), 21.3% (53.6%)/62.6% (88.8%) and 51.9% (84.8%)/66.4% (95.3%), respectively. Although the nitrite test showed higher positive rates in the pathogen groups (37.2%) than in the non-pathogen group (2.2%) and NMI group (1.3%), this was only marginally significant. CONCLUSION: The microscopic estimation of bacteria is more a predictable marker of bacteriuria, rather than leukocyte esterase, nitrite, and microscopic leukocytes, in urine.
Bacteria ; Bacteriuria* ; Humans ; Leukocytes* ; Microscopy ; Reagent Strips ; Urinalysis

Twenty-four patients with lower urinary tract infection have been treated with 7-day course of oral fosfomycin and following results were obtained. 1. Clinical result of 11 cases of acute uncomplicated infection was excellent in 10 and good in 1, efficacy rate being 100%. 2. Clinical result of 7 cases of complicated infection was excellent in 4, good in 1 and poor in 2, efficacy rate being 71%. 3. Clinical result of 4 cases of asymptomatic bacteriuria was excellent in 1 and poor in 3, efficacy rate being 25%. 4. Both 1 case of NGU and 1 case of acute epididymitis probably caused by Chlamydial or Mycoplasmal infection were not improved. 5. No significant side effect except mild headache and dizziness was observed. In conclusion, oral fosfomycin is a safe and very useful drug especially in the treatment of acute uncomplicated lower urinary tract infection.
Bacteriuria ; Dizziness ; Epididymitis ; Fosfomycin ; Headache ; Humans ; Male ; Urinary Tract Infections* ; Urinary Tract*

Accurate analysis of urinary calculi is fundamental for study of the etiology of stone formation and essential for treatment of urinary stone and its prevention. A total of 600 patients underwent treatments with ESWL for urinary tract calculi between May, 1987 and June, 1989. The stone fragments that were passed with 99 patient's urine and 21 stone calculi required surgical removal, were analyzed by infrared spectrometer. The following results were obtained : 1. Mixed calculus (58.3%) in much more than single calculus (41.7% ), The most common type of calculi is calcium oxalate-calcium phosphate (69 cases-57.5% ). The most common type of components is calcium oxalate (105 cases-87.5%). 2. Uric acid stones are found in acid urine, and most of magnesium ammonium phosphate stones are found in alkaline urine. 3. 17 of 120 cases have bacteriuria on culture and most of them are ureasplitting organisms. 4. 21 calculi of failed ESWL were analyzed and the components were calcium oxalate-calcium phosphate in 14, calcium oxalate in 4, magnesium ammonium phosphate in 2, uric acid in 1. 5. The causes of failed ESWL were stone components in 5 cases, impacted stone in 10 cases and poor stone localization in 6 cases.
Ammonium Compounds ; Bacteriuria ; Calcium ; Calcium Oxalate ; Calculi ; Humans ; Magnesium ; Uric Acid ; Urinary Calculi* ; Urinary Tract