Korean Journal of Nephrology 1991;10(3):343-351.

급성요로 감염에 관한 임상적 고찰

이종수 , 황병욱 , 김영수 , 곽임수 , 나하연

Abstract

The author analized the causative organism, inci- dence, underlying disease, and antibiotics sensitivity test, etc. in 213 patients who had been diagnosed acute urinary tract infection during 1 year from Jan. 1989 to Dec. 1989 at Pusan national Uriversity Hospital. The fllowing results were obtained 1) In evaluated patients, male were 102 and female were 111. The ratio of male td female was 1:1.1. The peak age incidence is fourth decade in male and third deeade in female 2) 235 bacteria were isolated by urine culture from 213 patients. In these cases, 22 (10. 3%) cases were mixed infection by 2 kinds of organisms and of them had underlying cause. The most common underlying cause was indwelling urinary catheter. 3) Among 235 isolates, 182 (77. 4%) was gram- negative bacteria, 43 (18.3%) was gram positive and 10 (4.3%) was candida. The most frequently isolated organism was E. coli (32.3,%0 and fllowed by pseudomonas (13,2%), enterococcus (9,8%), serratia (6, 8%), acinetobacter (6.0%), citrobacter (5.5%), in order. E. coli was more frequent in female (41.0%) than male (22.3%), but pseudomonas, klebsiella, fiavobacterium were more frequent in male than female. Other organ- isms were occurred with similar frequency in both sex. 4) There were significant bacteriuria without pyuria (WBC>5/HPF) in 14 cases (6.6%). 54 (23.2%) cases with significant bacteriuria were negative at urine nitrite test. There was no bacteria on direct smear and gram stain of urine in 33 patients (13.4%) who had significant bacteriuria. 5) There were 72 patients who had no underying cause. Among these patient E. coli was the most fre- quent organism (61.1%). Among the underlying causes, urinary catheter indwelling was the most common. The other underlying causes include urinary tract stone, urinary tract trauma, BPH, DM, neurogenic blad- der, VUR, pregnancy, etc. in or 8er of frequency. In complicated infection E. coli was the most common causative organism (19.6%) but was not marked compared to uncomplicated infection. The incidence of pseudomonas and mixed infection was much more fre- quent in complicated infection. 6) In antibiotics sensitivity test E. coli showed tendency of resistence to ampicillin (21.0% was sensitive). The main causative organism of nosocomial infection, pseudomonas, serratia, acinetobacter was resistent to most of antibiotics except drugs which developed rcent- ly.