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Clinical Features of Bacteremia Caused by Ciprofloxacin-Resistant Bacteria after Transrectal Ultrasound-Guided Prostate Biopsy
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Bo Sung Shin, Eu Chang Hwang, Seung Il Jung, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu, Jin Woong Kim
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Korean J Urogenit Tract Infect Inflamm 2011;6(1):61-66. Published online April 30, 2011
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 Abstract
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- "Purpose: Fluoroquinolone is considered the prophylactic antibiotic of choice for Transrectal ultrasound (TRUS)-guided biopsy. However, failure of quinolone prophylaxis due to emerging quinolone-resistant enterobacteriae has been increasing. We reviewed bacteremia cases after TRUS-guided biopsy to identify antibiotic-resistant bacterial strains with the objective to prevent urosepsis. Materials and Methods: A total of 2,348 patients underwent TRUS-guided biopsy at our institution between January 2004 and December 2009. All patients received intravenous ciprofloxacin for prophylaxis. We retrospectively evaluated patients who developed infectious symptoms, such as fevers and chills. Results: Eleven (0.4%) of 2,348 patients developed infectious symptoms. Escherichia coli was the pathogen responsible for post-biopsy infections occurring in a; 11 (100%) patients with positive blood cultures, which confirmed ciprofloxacin-resistant E. coli, with one isolate producing extended-spectrum beta lactamase. Ten out of 11 E. coli isolates (91%) were resistant to ampicillin and 9 of 11 E. coli isolates (82%) were resistant to gentamicin. Ten out of 11 E. coli isolates (91%) were susceptible to third generation cephalosporins. All such patients were admitted to the hospital and treated with a third generation cephalosporin. One patient who habored an E. coli isolate producing extended-spectrum beta-lactamase received imipenem. Conclusions: Ciprofloxacin is effective in reducing infectious complications. However, recently, bacteremiccases are increasing due to ciprofloxacin resistant E. coli. For patients with infectious symptoms after transrectal prostate biopsy, early antibiotics change, including third generation cephalosporins, are recommended to prevent urosepsis."
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Candida Infection Accompanying Glans Necrosis in Diabetic Patient
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Bo sung Shin, Hyunchong Ki, Eu chang Hwang, Chang Min Im, Sook Jung Yun, Seung IL Jung, Dong Deuk Kwon
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Korean J Urogenit Tract Infect Inflamm 2010;5(1):93-96. Published online April 30, 2010
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Abstract
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- Candida albicans is considered to be responsible for up to 35% of all cases of infectious balanitis. We report a man with glans necrosis with candidal infection. A 56 year old man visited our institute to consult for penile pain and black colored glans of penis. He had noted two months earlier due to gradually increased wounds, resulting in voiding difficulty. On the physical examination, there was hard necrotic lesion on the glans of penis with secondary meatal stenosis. Tissue culture and biopsy suggested candidial infection. We review the literature on the different forms of presentation of this condition and the differential diagnosis of ischemic penile lesions.
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