Causative Organisms of Urinary Tract Infection in Children, and their Antibiotic Susceptibility / 소아과

PURPOSE: In caring patients with urinary tract infection(UTI), it is prominent to know causative agents and their antimicrobial susceptibilities, of which domestic data appear somewhat different from those reported in the literature. The study was done to learn the distribution of pathogens causing UTI and their antimicrobial susceptibilities in Korean children. METHODS: One hundred forty two inpatients diagnosed with symptomatic UTI in the Department of Pediatrics, Hanyang University Hospital from 1997 to 2002 were retrospectively enrolled to analyze relevant information obtained from medical records, including causative agents of UTI and their antimicrobial susceptibilities. RESULTS: The average age of the study patients was 1.9 years with the peak in infants younger than 1 year of age(105 patients), of which 84 patients were younger than 6 months of age. The male to female ratio was 4:1 in or =1 year of age. Isolated organisms in urine cultures included Escherichia coli 83.1%, Klebsiella pneumoniae 6.3%, Proteus mirabilis 2.1%, and their distributions were not different, whether suprapubic specimen(100 patients) or non-suprapubic specimen(42 patients) was cultured. Antimicrobial susceptibility of E. coli was above 90% against ceftriaxone, ceftazidime, amikacin, 40-65% against trimethoprim-sulfamethoxasole, tobramycin, gentamicin, and 16.9% against ampicillin. CONCLUSION: E. coli was isolated in 83.1% of children with UTI, which is comparable to the data in the literature. The fact that susceptibility of E. coli was low to ampicillin, gentamicin, and trimethoprim-sulfamethoxasole indicates that the empiric and prophylactic choices of antimicrobials for UTI in Korean children should be investigated further.

Heart Rate Instability and Autonomic Modulation of the Heart Rate in Fetuses Affected by Severe Preeclampsia with or without Growth Restriction

No Abstract available.

A Clinical Study of Neurologic Abnormalities Associated with Rotavirus Gastroenteritis / 소아과

PURPOSE: Reports of neurologic abnormalities associated with acute diarrhea are increasing recently. It was reported that the incidence of the neurologic abnormalities related to gastroenteritis was higher in rotavirus gastroenteritis than in non-rotavirus gastroenteritis. We investigated the incidence, the manifestations and the prognosis of the neurologic abnormalities associated with rotavirus diarrhea and non-rotavirus diarrhea in Korean children. METHODS: Six hundred forty-nine children who showed acute diarrhea and whose stools were examined for rotavirus were enrolled and categorized into the rotavirus positive group(n=186) and the negative group(n=463). The medical records were reviewed retrospectively for neurologic manifestations, diagnoses and the status of follow-up. RESULTS:The incidence of neurologic abnormalities in all children with diarrhea was 9.4%. Neurologic abnormalities associated with diarrhea were more common in the rotavirus positive group than in the rotavirus negative group(16.1% vs 6.7%, P=0.0002). The neurologic diagnoses of the children ranged from simple febrile convulsion to encephalitis. The rate of patients presenting neurologic abnormalities other than seizures was relatively higher in the rotavirus positive group than in the rotavirus negative group(56.7% vs 25.8%, P=0.01). All children with neurologic abnormalities showed complete recovery. CONCLUSION: The incidence of neurologic abnormalities among patients with diarrhea was about 9%. The neurologic diagnoses in patients who showed neurologic abnormalities were diversed. In rotavirus gastroenterits, the rate of patients presenting neurologic abnormalities other than seizure was higher than in non-rotavirus gastroenteritis. The outcome of the children who showed neurologic abnormalities with diarrhea was excellent.