Usefulness of the transcutaneous bilirubinometer during phototherapy in neonatal jaundice / 소아과

PURPOSE: We studied the usefulness of transcutaneous bilirubinometers in follow-up of bilirubin levels during phototherapy in neonatal jaundice patients. METHODS: Transcutaneous bilirubin (TcB) was measured twice per day on 90 neonatal jaundice patients without risk factors of jaundice by transcutaneous bilirubinometer JM-103(Minolta/Hill-Rom Air-shields, Japan). TcB was measured simultaneously on the patched-forehead (TcB-PF), patched-chest(TcB-PC), unpatched-forehead (TcB-UF) and unpatched-chest (TcB-UC) of infants with neonatal jaundice. Plasma bilirubin (PB) was measured by American Optical bilirubinometer (American Optical Co, Buffalo, USA) within 30 minutes after transcutaneous bilirubinometer measurement. Each TcB was compared with PB. RESULTS: In the study group, the mean gestational age was 38.6+/-1.3 wk, the mean birthweight was 3,207.0+/-472.1 g, the mean age at start of phototherapy was 4.9+/-0.9 days and the mean duration of phototherapy was 1.3+/-0.6 days. The correlation between TcB and PB level was observed. The correlation between TcB of the patched part (TcB-PF, TcB-PC) and PB was more significant than that of the unpatched part (TcB-UF, TcB-UC) and PB. The most significant correlation was between PB and TcB-PC. CONCLUSION: TcB was useful in the follow-up of jaundice during phototherapy as well the screening of jaundice in neonatal jaundice patients. TcB of patched-chest area was the most reliable site in transcutaneous bilirubinometer examination in neonatal jaundice patients.

Antibiotic Sensitivity to the Major Causative Organisms of Acute Urinary Tract Infection in Children / 소아과

PURPOSE: We studied the changes in antibiotic sensitivity to the causative organisms of urinary tract infection (UTI), in order to provide useful information on the choice of adequate drugs in the treatment of UTI. METHODS: We retrospectively analyzed the major causative organisms and their antibiotic sensitivities in 69 patients diagnosed with UTI in the Department of Pediatrics, Samsung Cheil Hospital from 2002 to 2003. RESULTS: The frequency of UTI was the highest in infants younger than 1 year of age (88.4 percent). The male to female ratio was 3.05: 1. Escherichia coli was the most frequent organism (78.3 percent), followed by Klebsiella (116 percent), Pseudomonas (2.9 percent), Proteus (2.9 percent), Enterobacter, Morganelle, and Enterococcus (1.4 percent) in descending order. Antibiotic sensitivity of gram negative organisms was above 90 percent against imipenem, amikacin, 80 percent against aztreonam, cefepime, ceftriaxone, 50-70 percent against gentamicin, trimethoprime-sulfamethoxazole (TMP/SMX), and 23 percent against ampicillin (23.4 percent). CONCLUSION: Antibiotict sensitivity of gram negative organisms was high to amikacin and third generation cephalosporins but low to ampicillin, gentamicin and TMP/SMX. The use of ampicillin or TMP/SMX, as the first choice of the empiric and prophylactic treatment for UTI, should be reconsidered and investigated further.