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PubMed1987

The epidemiology of nontuberculous mycobacterial diseases in the United States. Results from a national survey.

During the 2-yr period 1981-83, demographic, clinical, and laboratory information was collected for 5,469 patients from whom nontuberculous mycobacteria (NTM) had been isolated. Among the potential NTM pathogens, isolates of Mycobacterium avium complex were most frequent, followed by M. kansasii, M. fortuitum, M. scrofulaceum, and M. chelonae. Almost 90% of the isolates were obtained from respiratory specimens. Prevalence rates for NTM disease, as calculated by a diagnostic algorithm, were highest for M. avium complex (1.3/10(5)), M. fortuitum-M. chelonae (0.2/10(5)). The data suggest a changing epidemiologic picture of NTM disease due perhaps to the decreasing incidence of tuberculosis, the increasing prevalence of chronic lung disease, and increased culturing of diagnostic specimens, as well as possibly a change in the ecology of these organisms.

Adolescent↗
PubMed2006

Secular trends of blood isolates in patients from a rural area population hospitalized in a tertiary center in a small city in Greece.

BACKGROUND: Most of the studies evaluating the secular trends of blood isolates come from tertiary hospitals in urban areas. We sought to study the trends of the antimicrobial resistance of blood isolates in patients from a rural population hospitalized in a tertiary hospital in a small city in Greece. METHODS: We retrospectively collected and analysed data for the first positive blood culture obtained for each admission for each patient hospitalized in General Hospital of Tripolis, Tripolis, Peloponnesus, Greece during a 5 year period (16/05/2000-15/05/2005). RESULTS: Sixty-seven thousand and seventy patients were hospitalized during the study period from whom 3,206 blood cultures were obtained. A higher increase of the number of obtained blood cultures than the number of admissions was noted during the study period (p < 0.001). Three hundred and seventy-three (11.6%) blood cultures were positive. Coagulase-negative staphylococci (35.9%), Escherichia coli (29%), and Staphylococcus aureus (18.2%) were the most commonly isolated pathogens. Among the Staphylococcus aureus isolates, the proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 17.2% (5/29). The proportion of Escherichia coli resistant to trimethoprim and sulfamethoxazole, ampicillin and cefuroxime was 29.6% (32/108), 25.0% (27/108), and 8.3% (9/108) respectively. Imipenem-resistance was noted in 3.4% (1/29) of Pseudomonas aeruginosa isolates. There were only 6 (1.6%) Acinetobacter baummanii blood isolates during the study period. CONCLUSION: The antimicrobial resistance of isolates from patients receiving care at the studied tertiary hospital in a small city in Greece is considerably less compared to that noted in tertiary hospitals in larger cities of the country.

Bacteremia↗
PubMed2003

[The influence of the initial antibacterial treatment effectiveness, clinical and etiological factors on non-resolvent severe pneumonia and outcome].

AIM: To evaluate the influence of the initial pneumonia treatment effectiveness, clinical and etiological factors, local innate immune response intensity on pneumonia non-resolution and mortality. MATERIALS AND METHODS: One hundred one bronchoscopy and bronchoalveolar lavage performed to 68 severe community (CAP) or hospital-acquired pneumonia patients survived during initial 5-7-day treatment period. Initial treatment effectiveness, age, pneumonia type, presence of mechanical ventilation, comorbidities, coma, antibacterial treatment, pathogen isolation and treatment changes were assessed. Logistic regression analysis was performed to detect factors associated with non-resolving pneumonia and mortality. RESULTS: Etiotropical treatment was administered to 30.9% of patients. Initial antibacterial treatment was corrected in 64.7% of all cases. After 21-30 days from the pneumonia onset survived 66.2% of patients (n=43). Pneumonia course could be evaluated in 52 cases. Delayed resolution of the pneumonia was stated in 32.7% of cases (n=17). Pneumonia was cured or condition improved in 64.3% of the CAP patients (n=9) and 68.4% of the hospital-acquired pneumonia patients (n=26). Only ineffective initial pneumonia treatment significantly increased probability of non-resolving pneumonia on multivariate analysis (OR 16.92, 95% CI 2.02-141.72, p<0.05). Influence of etiotropic treatment was not significant. Isolation of two or more pathogens from bronchoalveolar lavage fluid after the initial treatment was significantly associated with mortality on multivariate analysis (OR 6.25, CI 1.06-36.74, p<0.05). The other analyzed variables had no significant influence on pneumonia resolution and outcome. In conclusion, the initial pneumonia treatment failure increases probability of the non-resolving pneumonia. Etiotropical treatment has no impact on pneumonia outcome when adequate empirical antibacterial treatment is administered, however, it allows to reduce unnecessary use of the broad-spectrum antibacterials. Mortality is associated with the presence of the polymicrobial infection after the initial pneumonia treatment.

APACHE↗
PubMed1992

Screening for Listeria monocytogenes and other related species from faecal specimens at the Lagos University Teaching Hospital, Lagos.

Four hundred and twenty faecal specimens from patients with acute gastroenteritis and apparently healthy persons who reported at the Lagos University Teaching Hospital (LUTH) between October, 1988 and May, 1989 were investigated for faecal carriage of Listeria monocytogenes and other related species. Of these specimens, none was positive for Listeria species. However, the mannitol--fermenting Listeria species now Murraya grayi sub species grayi and Murraya grayi sub spp. murrayi representing 0.95% (4 out of 420) were isolated. Other well known enteric pathogens isolated in the course of this study were Escherichia coli (11.4%), Salmonella typhi (7.1%) and Yersinia species (1.4%).

Acute Disease↗
PubMedDate not supplied

[Isolation and study of biological properties of non-oncogenic Marek's disease herpesviruses in chickens. 2. Characterization in vivo].

In a previous paper (Jurajda and Halouzka, 1992) the in vitro isolation of two chicken herpesviruses of Marek's disease (M and K strains) was described and results of their characterization were presented. The present paper deals with the in vivo characterization of both isolates: pathogenicity and immunosuppressive characteristics of isolates were observed in a five-week test period, along with the development and production dynamics of antibodies and viral antigen in the feathers of experimentally infected chickens of the Brown Leghorn breed. A technique of double immunodiffusion in agar gel according to Ouchterlony, modified by Woernl (1966), was used to determine the presence of antibodies to Marek's disease virus (MDV) in blood serum and of precipitating MDV-antigen in feather quills of tested chickens. Isolate multiplication and titration were performed in a system of chicken embryonal fibroblasts (CEF) (Jurajda et al., 1984). Chickens were infected i.m. with three virus doses - 10(2) to 10(4) PFU per chicken while the dose 10(4) corresponded to the titre of 10,800 PFU/0.2 ml for M isolate and to the titre of 8,600 PFU/0.2 ml for K isolate. The nature and rate of regressive changes in lymphatic organs were determined according to criteria described by Halouzka and Jurajda (1991). The results are summarized in Tabs. I and II. Neither of the isolates evoked clinical or pathomorphological macroscopic symptoms of the disease. M isolate induced microscopic MD-specific changes in the peripheral nerves (of C type) and only moderate and transient signs of immunosuppression in 11% of infected chickens.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Comparison of fleroxacin and amoxicillin in the treatment of uncomplicated urinary tract infections in women.

Fleroxacin, 400 mg, was compared with amoxicillin, 3,000 mg, each administered orally in a single dose, for the treatment of women with acute uncomplicated symptomatic urinary tract infections. A total of 142 patients were randomized to receive fleroxacin, and 147 patients to receive amoxicillin. Of these, 33 in the fleroxacin group and 39 in the amoxicillin group were considered bacteriologically evaluable. Cure at 5-9 days after treatment was achieved in 32 (97%) of the fleroxacin-treated patients and in 22 (56%) of the amoxicillin-treated patients (p < 0.001). For the most frequently isolated pathogen (Escherichia coli), all 24 isolates were eradicated in the fleroxacin group, as were 11 of 25 in the amoxicillin group. At 6 weeks after therapy, bacteriologic cure was maintained in 20 (95%) of the 21 evaluable patients who received fleroxacin and in 8 (89%) of 9 evaluable patients who received amoxicillin. There were no reinfections in either group. A total of 280 patients were assessed for safety. Clinical adverse events were reported in 32 (23%) of 137 patients in the fleroxacin group and in 19 (13%) of the 143 patients in the amoxicillin group. In both groups, the most common adverse effects were gastrointestinal, while adverse events involving the central nervous system were more frequent in patients who received fleroxacin. On the basis of this study, it appears that fleroxacin is demonstrably more effective than amoxicillin as single-dose therapy for uncomplicated urinary tract infection.

Adolescent↗
PubMed1997

Acute diarrhea in under five-year-old children admitted to King Mongkut Prachomklao Hospital, Phetchaburi province.

A prospective epidemiological and clinical study of acute diarrhea in children under 5 years old was done at King Mongkut Prachomklao Hospital in order to provide baseline data for health officers to make a strategic plan to reduce the diarrheal mortality and morbidity, which is one of the mid-decade goals for children. There were 105 cases of acute diarrhea patients admitted to the Pediatric ward between May 1995 and April 1996. Seventy-six per cent of them were in the younger age group (> 1 month-2 years old) while 23.8 per cent were in the older age group (2-5 years old). Causative pathogens were identified in 64 patients (61%). Younger patients had a higher percentage of identifiable pathogens (66.7%) than older patients (44.4%). Rotavirus was the most common pathogen isolated (17.2%). The other common pathogens identified were Eschericia coli (14.1%), Campylobacter jejuni (14.1%), Shigella (12.5%), Entamoeba histolytica (7.8%) and Salmonella (3.1%). Mixed infections were reported in 31.3 per cent of these patients. Clinical presentations and stool characteristics were difficult to distinguish from most of the pathogens. However, Rotavirus was highly suspected if a younger child presented with fever, watery to loose stool with the predominant symptom of vomiting. Mucous, mucous-bloody stool gave a clue to the diagnosis of Shigella and Entamoeba histolytica. Most cases had at least mild to moderate dehydration, so oral rehydration solution (ORS) was successfully given in only 31.4 per cent of patients. Antibiotics were prescribed to 51.4 per cent of patients in this study. Healthcare personnel should emphasize to parents and caretakers about good hygienic behavior to reduce the episodes of diarrhea and the use of ORS every time when their children have diarrheal episodes to reduce the disease severity.

Acute Disease↗
PubMed1997

Characteristics of childhood diarrhea associated with enterotoxigenic Escherichia coli in Malaysia.

Amongst 107 diarrheal cases studied a bacterial agent was isolated from 71 (66%) cases of which 60 (85%) were due to a single agent and the remaining 11 (15%) were of mixed infections. Enterotoxigenic Escherichia coli (ETEC) was isolated from 65 cases. Other pathogens isolated included Salmonella spp, Shigella spp and rotavirus. There was a higher isolation rate of ETEC from females and rotavirus from males. The infection rate was found to higher for the 0-2 year age group as compared to the 3-5 year age group. Amongst the ETEC isolated the STa 2 toxotype was the predominant type.

Child, Preschool↗
PubMed2005

Antimicrobial susceptibility and molecular characterization of avian pathogenic Escherichia coli isolates.

Ninety-five avian pathogenic Escherichia coli (APEC) isolates recovered from diagnosed cases of avian colibacillosis from North Georgia between 1996 and 2000 were serotyped and examined for typical virulence-factors, susceptibility to antimicrobials of human and veterinary significance, and genetic relatedness. Twenty different serotypes were identified, with O78 being the most common (12%). The majority of the avian E. coli isolates (60%), however, were non-typeable with standard O antisera. Eighty-four percent of isolates were PCR positive for the temperature-sensitive hemagglutinin (tsh) gene and 86% positive for the increased serum survival (iss) gene. Multiple antimicrobial-resistant phenotypes (> or =3 antimicrobials) were observed in 92% of E. coli isolates, with the majority of isolates displaying resistance to sulfamethoxazole (93%), tetracycline (87%), streptomycin (86%), gentamicin (69%), and nalidixic acid (59%). Fifty-six E. coli isolates displaying resistance to nalidixic acid were co-resistant to difloxacin (57%), enrofloxacin (16%), gatifloxacin (2%), and levofloxacin (2%). DNA sequencing revealed point mutations in gyrA (Ser83-Leu, Asp87-Tyr, Asp87-Gly, Asp87-Ala), gyrB (Glu466-Asp, Asp426-Thr), and parC (Ser80-Ile, Ser80-Arg). No mutations were observed in parE. Twelve of the quinolone-resistant E. coli isolates were tolerant to cyclohexane, a marker for upregulation of the acrAB multi-drug resistance efflux pump. Quinolone-resistant isolates were further genetically characterized via ribotyping. Twenty-two distinct ribogroups were identified, with 61% of isolates clustering into four major ribogroups, indicating that quinolone resistance has emerged among multiple avian pathogenic E. coli serogroups and chromosomal backgrounds.

Animals↗
PubMed1990

Isolation of very virulent Marek's disease viruses from vaccinated chickens in Australia.

Very virulent Marek's disease viruses (vvMDV), defined as isolates against which the herpesvirus of turkey (HVT) vaccine provide poor protection, have been isolated from poultry flocks in both the United States and Europe. Twenty-one samples from vaccinated Australian flocks, experiencing problems with excessive Marek's disease (MD), were tested for the presence of transmissible MD viruses (MDV). Of the 16 samples which contained a transmissible agent, 14 were pathogenic in chickens, based on the development of MD lesions or depression of the bursa/body weight ratio. Of the pathogenic isolates which have been successfully typed 10 were serotype 1, and one was serotype 2 MDV. Pathogenicity of isolates varied. Several isolates caused tumours in 20-30% of both vaccinated and unvaccinated chickens. Two isolates, MPF6 and MPF23, caused tumours in more than 50% of chickens. When MPF6 and MPF23 were tested in vaccine trials bivalent vaccine gave no better protection against development of MD lesions than a monovalent vaccine. Isolate MPF23 was so pathogenic that lesions were produced in all chickens, regardless of the vaccine protocol used. Therefore vvMDV have been isolated in Australia, and unlike the vaccines tested overseas, bivalent Australian vaccines do not appear to provide greater protection against these vvMDV.

Animals↗
PubMed2000

Role of the male partner in the lower genitourinary tract infection of female.

We studied the relationships of selected microbes and the role of consorts in the causation of vaginal discharge which may be due to cervicitis or vaginitis. A total of 93 consecutive patients in the reproductive age group with symptoms of vaginal discharge along with their sexual partners were studied. Samples were collected from the cervix and posterior fornix of the female patients and from the urethra and sub-prepucial area of the male partner for culture of Neisseria gonorrhoeae, Gardnerella vaginalis, Mycoplasma hominis, ureaplasma, candida, aerobic and anaerobic organisms. Apart from cultures, KOH and Gram stain of the discharge were made. Predominant pathogen isolated was Ureaplasma urealyticum from 40 (43.01%) females and 23 (24.7%) males. The next common pathogenic organisms isolated were candida species from 11 (11.8%) females and 5 (5.4%) males and Chlamydia trachomatis in 3 (3.2%) females and 1 (1.1%) male. Various organisms were more frequently isolated from the 29 of 43 (67.4%) couples who had had sexual intercourse 7 days prior to the recruitment as compared to 14 of 43 (32.6%) who had had coitus more than 7 days prior to their recruitment. This may be due to the spontaneous disappearance or decrease in the number of organisms to the level that they could be detected by culture. In our study, 6 (6.5%) of male partners carrying pathogenic organisms were asymptomatic, indicating that their screening and treatment is vital.

Adult↗
PubMed2002

Enteropathogens associated with acute diarrhea in community and hospital patients in Jakarta, Indonesia.

The prevalence of bacteria, parasite and viral pathogens in 3875 patients with diarrhea in community and hospital settings from March 1997 through August 1999 in Jakarta, Indonesia was determined using routine bacteriology and molecular assay techniques. Bacterial pathogens isolated from hospital patients were, in decreasing frequency, Vibrio cholerae O1, Shigella flexneri, Salmonella spp. and Campylobacter jejuni, while S. flexneri, V. cholerae O1, Salmonella spp. and C. jejuni were isolated from the community patients. V. cholerae O1 was isolated more frequently (P<0.005) from the hospital patients than the community patients. Overall, bacterial pathogens were isolated from 538 of 3875 (14%) enrolled cases of diarrhea. Enterotoxigenic Escherichia coli were detected in 218 (18%) of 1244 rectal swabs. A small percentage of enterohemorrhagic E. coli (1%) and of Clostridium difficile (1.3%) was detected. Parasitic examination of 389 samples resulted in 43 (11%) positives comprising Ascaris lumbricoides (1.5%), Blastocystis hominis (5.7%), Giardia lamblia (0.8%), Trichuris trichiura (2.1%) and Endolimax nana (0.5%). Rotavirus (37.5%), adenovirus (3.3%) and Norwalk-like virus (17.6%) were also detected. Antimicrobial resistance was observed among some isolates. Bacterial isolates were susceptible to quinolones, with the exception of some isolates of C. jejuni which were resistant to ciprofloxacin, nalidixic acid and norfloxacin. Data obtained from this community- and hospital-based study will enable the Indonesian Ministry of Health to plan relevant studies on diarrheal diseases in the archipelago.

Acute Disease↗
PubMed2002

An evaluation of cefaclor in Pakistani children with pharyngotonsillitis.

OBJECTIVE: To assess the efficacy, safety of cefaclor for the treatment of pharyngotonsillitis in Pakistani children. METHOD: Pakistani children between the ages of two to twelve years and diagnosed with pharyngotonsillitis were eligible to participate in the study. Cefaclor was administered three times daily for a total dose of 20-40 mg/kg/day, depending on the severity of the infection, for 7 days. Patients were evaluated on the basis of symptomatic response and antibiotic susceptibility pattern as a result of bacteriological examination. RESULTS: Based on observed pre-therapy signs/symptoms of infection with pharyngotonsillitis, 99% of patients (95% CI=94.9% to 100.0%) were reported as having a symptomatic response of Cure or Improvement by end of study. Group A b-haemolytic Streptococci was the most prevalent pathogen isolated pre-therapy (occurring in 45% of patients). Of all patients for whom this pathogen was isolated, 64% had complete eradication by end of therapy, while there was persistence or superinfection in 36% of patients. Only 9 occurrences of non-serious adverse events were observed among 7 of the 107 patients, including diarrhea (5), nausea (1), vomiting (1), rash (1) and stomatitis (1). CONCLUSION: Based on the high symptomatic response rate of 99% and the positive safety data, cefaclor was found to be effective and safe in treating Pakistani children with pharyngotonsillitis.

Anti-Bacterial Agents↗
PubMed1999

An African swine fever virus ORF with similarity to C-type lectins is non-essential for growth in swine macrophages in vitro and for virus virulence in domestic swine.

An African swine fever virus (ASFV) ORF, 8CR, with similarity to the C-type lectin family of adhesion proteins has been described in the pathogenic isolate Malawi Lil-20/1. The similarity of 8CR to cellular and poxvirus genes associated with cell adhesion, cell recognition and virus infectivity suggested that 8CR may be of significance to ASFV-host cell interactions. Sequence analysis of the 8CR ORF from additional pathogenic ASFV isolates demonstrated conservation among isolates from both pig and tick sources. Northern blot analysis demonstrated 8CR mRNA transcription late in the virus replication cycle. A Malawi Lil-20/1 8CR deletion mutant (delta8CR) was constructed to analyse 8CR function further. The growth characteristics in vitro of delta8CR in porcine macrophage cell cultures were identical to those observed for parental virus. In domestic swine, delta8CR exhibited an unaltered parental Malawi Lil-20/1 disease and virulence phenotype. Thus, although well conserved among pathogenic ASFV field isolates, 8CR is non-essential for growth in porcine macrophages in vitro and for virus virulence in domestic swine.

African Swine Fever↗
PubMed2005

Intraspecies genetic variability of Ornithobacterium rhinotracheale in commercial birds in Peru.

Strains of the bacterium Ornithobacterium rhinotracheale (ORT), a causal agent of respiratory diseases in birds, were microbiologically isolated, identified, and molecularly characterized. Blood-enriched culture media and biochemistry tests were used for microbiologic identification. Polymerase chain reaction (PCR) and repetitive extragenic palindromic PCR (rep-PCR) techniques were used for molecular identification and characterization, respectively, of the microorganism. ORT strains were isolated in enriched media from the trachea and air sacs of broilers, breeders, and layers from several geographic zones of Peru. Of the original 75 strains isolated from 75 clinical samples from which ORT was recovered during 1998-2000, 25 were selected for further study based on ORT as the primary pathogenic isolate (no other pathogens were detected). Selected isolates were molecularly identified and characterized by PCR using specific primers designed from the conserved zones of the 16S ribosomal genes. Primers used for the identification of ORT produced a specific fragment of 784 base pair (bp), which did not appear in Haemophilus paragallinarum or Pasteurella multocida, microorganisms with similar morphologic and biochemical characteristics that produce dinical signs identical to those of ORT. All 25 strains of ORT tested with rep-PCR had a genetic profile similar to that of ORT American Type Culture Collection 51463, indicating the presence of only one genotype in the ORT strains studied.

Animals↗
PubMed1995

Seasonal distribution of pathogenic free-living amebae in Oklahoma waters.

Pathogenic free-living amebae cause serious human disease, including infection of the eye and the central nervous system. The purpose of this study was to sample aquatic environments in the Tulsa, Oklahoma, area year-round for the presence of these disease-causing amebae. A total of 34 pathogenic isolates were obtained from 2,016 processed water and swab samples. Pathogenicity was determined by the ability of amebae to cause death in mice after intranasal inoculation. Pathogenic amebae were isolated during every month of the year and were identified as Naegleria australiensis (38%), Acanthamoeba species (35%), N. fowleri (18%), and leptomyxid amebae (9%). Pathogenic leptomyxids have not previously been reported from the environment. The greatest percentage of recovery of pathogens occurred during the spring and autumn. The prevalence of pathogenic free-living amebae in the sampled waters was 1 pathogen/3.4 l water.

Acanthamoeba↗
PubMed2004

Low autocrine interferon beta production as a gene therapy approach for AIDS: Infusion of interferon beta-engineered lymphocytes in macaques chronically infected with SIVmac251.

BACKGROUND: The aim of this study was to evaluate gene therapy for AIDS based on the transduction of circulating lymphocytes with a retroviral vector giving low levels of constitutive macaque interferon beta production in macaques chronically infected with a pathogenic isolate of SIVmac251. RESULTS: Two groups of three animals infected for more than one year with a pathogenic primary isolate of SIVmac251 were included in this study. The macaques received three infusions of their own lymphocytes transduced ex vivo with the construct encoding macaque IFN-beta (MaIFN-beta or with a vector carrying a version of the MaIFN-beta gene with a deletion preventing translation of the mRNA. Cellular or plasma viremia increased transiently following injection in most cases, regardless of the retroviral construct used. Transduced cells were detected only transiently after each infusion, among the peripheral blood mononuclear cells of all the animals, with copy numbers of 10 to 1000 per 106 peripheral mononuclear cells. CONCLUSION: Long-term follow-up indicated that the transitory presence of such a small number of cells producing such small amounts of MaIFN-beta did not prevent animals from the progressive decrease in CD4+ cell count typical of infection with simian immunodeficiency virus. These results reveal potential pitfalls for future developments of gene therapy strategies of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1989). II. Background of patients].

Clinical background was investigated on 1,197 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during the period from June, 1989 to May, 1990. 1. Distribution of sex and age A majority of female patients with UTIs accounted for a twenties and thirties. The proportion of male patients with UTI has increased with age, accounting for majority in patients 70 years or older. 2. Distribution of infection types and age Most cases among twenties or thirties were uncomplicated UTIs. Fifties and older cases were most frequent in complicated UTIs. 3. Distribution of isolated bacteria and age Escherichia coli was most frequent on the whole, followed by Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus spp. and Klebsiella spp.. E. coli had declined with age, and on the other hand, E. faecalis and P. aeruginosa had increased with age. 4. Administration of antibiotics and pathogens isolated from UTIs. In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 439 to 4. Before an administration of antibiotics, E. coli was mainly detected, but after an administration of antibiotics, E. coli has decreased into two strains. After administration of antibiotics, pathogens of complicated UTIs, without indwelling catheter, have decreased from 324 to 19: E. coli has decreased from 86 to 2, but E. faecalis, Staphylococcus spp., Enterobacter spp. and P. aeruginosa have increased. Pathogens of complicated UTIs with indwelling catheter, have decreased from 156 to 14 after administration of antibiotics, and mainly isolated pathogens were E. faecalis and P. aeruginosa.

Adolescent↗