요로감염을 일으킨 대장균의 항생제 감수성 변화에 대한 고찰(1984~1988) = A Study for the Changes of Antibiotics Sensitivity to the E.coli Causing Urinary Tract Infection (1984-1988)

다국어 초록 (Multilingual Abstract)

Urinary tract infection is one of the most common urological disease, and causes major noscomial infection. These infections are caused by gram negative rods, especially Escherichia coli. Recently it is pointed out that the sensitivity changes of antibiotics to the urinary infecting organism is attributed to drug abuse. After the analysis of 275 patients whose urine culture showed growth of E. coli over 100,000 colony per mililiter for the period of 5 years from January 1984 to December 1988 in terms of age and sex dietribution, yearly distribution according to age group, seasonal distribution and changes of antibiotics sensitivities, the results can be summarized as follows.
1. The age distribution of E. coli observed 35.6 percent and 12.4 percent for the age of 2 to 10, 11 to 20, 21 to 40, 41 to 60 and over 61 years, respectively.
2. The overall male to female distribution ratio of urinary infection revealed approximately 1 to 2. For the age of under one, the sex ratio was equally distributed and 1:1.3 and 1:5.2 for 2 to 10 and over 11 years, respectively.
3. The amikacin and sisomycin revealed relatively high sensitivity rates such as 94.6-98.2 percent and 90.9-94.6 percent, respectively, for the period of 5 years. And gentamicin and tobramycin maintained 80.0-92.7 percent of sensitivity. However the sensitivity of kanamycin and minocycline showed 56.4, 47.3 percent in 1984 and declined to 40.0 and 25.5 percent in 1988 respectively, while cefazolin showed 49.1 percent in 1984 and 50.9 percent in 1988. Trimethoprim-sulfamethoxazole and chloramphenicol revealed 41.8 percent, 25.5 percent in 1984, and 50.9 percent, 41.8 percent in 1988. Ampicillin and carbenicillin showed 20.0 percent, 18.2 percent in 1984, and 12.7 percent and 14.6 percent in 1988.
4. The overall sensitivities of amikacin was 97.1 percent and 88.7 percent for tobramycin, 87.6 percent for sisomycin, 47.7 percent for kanamycin, 49.5 percent for cefazolin, 46.2 percent for trimethoprim-sulfamethoxazole, 16.4 percent for ampicillin, 16.4 percent for carbenicillin.
One of the reason for the reduced and decreased sensitivity of the most antibiotics in this country is attributed to the drug abuse while these drugs are still widely used with farely good effectiveness in the western countries. Thus, it should be corrected the current drug delivery system such as patients can purchase antibiotics without prescription of medical doctors. Also, doctors should pay attention to the sensitivity preservation of antibiotics in terms of accurate diagnosis and treatment of urinary tract infection.