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Ureteral Stent Induced Urinary Tract Infection and Microbial Inconsistency Between Bladder and Renal Pelvis
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Useok Choi, Eun Jae Kim, Don Hee Lyu, Bong Hee Park, Hong Chung, Chang Hee Han, Sangrak Bae
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Urogenit Tract Infect 2021;16(3):61-66. Published online December 31, 2021
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DOI: https://doi.org/10.14777/uti.2021.16.3.61
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- Purpose: This study examined the effects of long-term ureteral stent (US) on urinary tract infection (UTI) by bacterial migration and bacterial colonization.
Materials and Methods: From March 2014 to August 2021, 64 patients who underwent US for more than six months were enrolled in this study. When the US was inserted for the first time and replaced regularly, urine was collected from the bladder and renal pelvis and cultured. Patients’ the characteristics, and differences in pathogens related to US infection were analyzed.
Results: The mean age was 66.4 years, and the mean duration of indwelling was 37.5 months. There were 38 cases (59.3%) by malignant and 26 cases (40.6%) by benign causes. UTI occurred in 33 cases (53%); 16 cases (25%) were hospitalized for febrile UTI. After the initial US insertion, bacteria were identified in the bladder 285 days later and in the renal pelvis after 619 days. The bladder culture was positive in 10 of the 33 patients, and renal pelvis alone was positive in nine of the 33 patients. The same strain was confirmed in the bladder and renal pelvis in 12 cases (18.8%), and it took a mean of 5.8 months ± 6.32 (standard deviation) for the upward migration of bacteria.
Conclusions: UTIs occur in approximately 50% of patients with long-term US indwelling. The probability of culturing the same strain by a US was approximately 18.8%, and the role of pathogen transmission of a US does not appear to be significant. In addition, renal pelvis culture would be helpful in cases of failed bladder antibiotics susceptibility.
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Infectious Complications after Prostate Biopsy: A Prospective Multicenter Prostate Biopsy Study
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Eu Chang Hwang, Ho Song Yu, Seung Il Jung, Dong Deuk Kwon, Sun Ju Lee, Tae-Hyoung Kim, In Ho Chang, Hana Yoon, Bongsuk Shim, Kwang Hyun Kim, Donghyun Lee, Jung-Sik Huh, Dong Hoon Lim, Won Jin Jo, Seung Ki Min, Gilho Lee, Ki Ho Kim, Tae Hwan Kim, Seo Yeon Lee, Seung Ok Yang, Jae Min Chung, Sang Don Lee, Chang Hee Han, Sang Rak Bae, Hyun Sop Choe, Seung-Ju Lee, Hong Chung, Yong Gil Na, Seung Woo Yang, Sung Woon Park, Young Ho Kim, Tae Hyo Kim, Won Yeol Cho, June Hyun Han, Yong-Hyun Cho, U-Syn Ha, Heung Jae Park, The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII)
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Urogenit Tract Infect 2016;11(1):17-24. Published online April 30, 2016
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- Purpose: Recent studies have highlighted an increasing trend of infectious complications due to fluoroquinolone-resistant organisms among men undergoing transrectal prostate biopsy. This study evaluated the current incidence of infective complications after trans-rectal prostate biopsy for identification of risk factors in Korean men who received fluoroquinolone prophylaxis.
Materials and Methods: A prospective, multicenter study was conducted in Korea from January to December 2015. Prostate biopsies performed with fluoroquinolone prophylaxis during 3 months in each center were included. A pre-biopsy questionnaire was used for identification of patient characteristics. Clinical variables including underlying disease, antibiotic prophylaxis, enema, povidoneiodine cleansing of the rectum, and infectious complications were evaluated. The primary outcome was the post-biopsy infection rate after fluoroquinolone prophylaxis. Univariable and multivariable analyses were used for identification of risk factors for infectious complications.
Results: The study included 827 patients, of whom 93 patients (11.2%) reported receiving antibiotics in the previous 6 months and 2.5% had a history of prostatitis. The infectious complication rate was 2.2%. Post-biopsy sepsis was reported in 2 patients (0.2%). In multivariable analysis predictors of post-biopsy sepsis included person performing biopsy (adjusted odds ratio [OR], 4.05; 95% confidence interval [CI], 1.31-12.5; p=0.015) and operation history within 6 months (adjusted OR, 5.65; 95% CI, 1.74-18.2; p=0.004).
Conclusions: The post-prostate biopsy infectious complication rate in this study was 2.2%. Person performing biopsy (non-urologists) and recent operation history were independent risk factors for infectious complications after trans-rectal prostate biopsy.
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Anti-Inflammatory Effect of Phlorotannin on Chronic Nonbacterial Prostatitis in a Rat Model
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Yun Seok Jung, Yong-Hyun Cho, Chang Hee Han
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Korean J Urogenit Tract Infect Inflamm 2014;9(2):86-92. Published online October 31, 2014
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Chronic nonbacterial prostatitis and chronic pelvic pain syndrome account for 90-95% of all prostatitis. Little is known about its pathophysiology, thus, various treatments are used. Ecklonia cava, a seaweed, is a member of the brown algae family; many recent reports have demonstrated that its extract containing phlorotannin has anti-oxidative and anti-inflammatory properties. Using the hormone-induced prostatitis rat model, we investigated the anti-inflammatory effects of E. cava extracts via its anti-oxidative process on chronic nonbacterial prostatitis. Materials and Methods: Forty, 10-week-old male white Wistar rats were utilized, and divided equally into the following five groups: 1) control, 2) E. cava-fed, 3) hormone-induced prostatitis (HIP), 4) E. cava-treated HIP, and 5) nonsteroidal anti-inflammatory drug (NSAID)-treated HIP. Results: The results showed statistically-significant improvement in the tissue response to the hormone-induced inflammation among the E. cava-treated and NSAID-treated groups (p＜0.05). Lower malonedialdehyde levels were observed in the group with E. cava-treated HIP than with HIP alone, which was statistically significant. We believe that this supports the anti-oxidative properties of E. cava. Conclusions: This study demonstrates that phlorotannin has anti-inflammatory properties via its anti-oxidative process, which we expect to play an important role in prevention and as an adjuvant therapy for chronic nonbacterial prostatitis.
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Functional Foods: Role in Disease Prevention and Health Promotion
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Chang Hee Han
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Korean J Urogenit Tract Infect Inflamm 2012;7(1):10-19. Published online April 30, 2012
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- The term, functional foods, was first introduced in Japan in the mid-1980s and it refers to processed foods that contain ingredients that aid specific bodily functions in addition to being nutritious. The Institute of Medicine's Food and Nutrition Board (IOM/FNB, 1994) defined functional foods as "any food or food ingredient that may provide a health benefit beyond the traditional nutrients it contains". This article reviews the literature for the primary plant and animal foods that have been linked with physiological benefits. Although a plethora of biologically-active compounds have been identified in this regard, this review focuses on foods, rather than specific compounds isolated from foods.
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Clinical Outcome of Acute Bacterial Prostatitis; A Multicenter Study
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Seong Ju Lee, Jin Mo Koo, Bong Suk Shim, Yong Hyun Cho, Chang Hee Han, Seung Ki Min, Sung Joo Lee, Hwan Cheol Son, Jun Mo Kim, Jong Bo Choi, Tae Hyoung Kim, Sang Kuk Yang, Kil Ho Lee, Yong Kil Na, Sung Ho Lee, Hee Jong Jung, Seung Il Jung, Chul Sung Kim, Jae Min Chung, Young Jin Seo, Won Yeol Cho, Kweon Sik Min, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2011;6(2):165-170. Published online October 31, 2011
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- "Purpose: Proper guidelines concerning antibiotic administration for acute bacterial prostatitis (ABP) are unclear. We retrospectively analyzed treatment status and clinical outcomes to establish a proper treatment guideline. Materials and Methods: The clinical records of 669 patients from 21 hospitals diagnosed with ABP were reviewed. Prior manipulation, antibiotics administration, mean length of treatment, complication and procedure were analyzed. Results: The mean age of 538 patients (80.4%) without manipulation (group 1) and 131 patients (19.6%) with manipulation (group 2) was 58.3 years (range 19-88 years). Transrectal prostate biopsy was the most common cause of acute bacterial prostatitis (n=66; 50.4%). Of the clinical symptoms in the non-manipulation and manipulation groups, fever was most common (88.2% and 86.3%, respectively). Acute urinary retention (14.3% and 28.1%, respectively) was significantly increased in the manipulation group (p<0.05). Escherichia coli was the most frequently isolated bacterium from urine (72.0% and 66.7% of cases, respectively). Mean length of treatment was 6.5days and 7.9days, respectively; the difference was significant (p<0.05). Combination antibiotic therapy with third generation cephalosporin+aminoglycoside was used in 49.3% and 55.5% of cases, respectively. For single antibiotic therapy, second generation quinolones were used the most (35.5% and 34.3%, respectively). Sequale occurred in 29 group 1 patients (5.4%) and 20 group 2 patients (15.3%); the difference was significant (p<0.05). Conclusions: Prior manipulation was associated with 20% of ABP patients. Regardless of manipulation, clinical outcome was similar after treating with appropriate antibiotics."
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Treatment and Prevention of Catheter-Associated Urinary Tract Infections
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Seung Hyuk Yim, U-Syn Ha, Dong Wan Sohn, Seung-Ju Lee, Chang Hee Han, Choong Bum Lee, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):159-169. Published online October 31, 2009
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- Urinary tract infections (UTIs) represent the second most often observed infectious diseases in community, following the respiratory tract infections. Approximately 40% of nosocomial infections originate in the urinary tract; about 80% of urinary tract infections is related to urinary catheterization. The duration of catheterization is the most important risk factor for development of UTIs and additional risk factors include female sex, diabetes mellitus, renal function impairment, lack of antimicrobial therapy, and not maintaining a closed drainage system. There are many methods for preventing catheter-associated urinary tract infections (CAUTI); (i) an indwelling catheter should be introduced under antiseptic conditions; (ii) urethral trauma should be minimized by the use of adequate lubricant and the smallest possible catheter; (iii) the catheter system should remain closed; and (iv) the duration of catheterization should be minimal. Antimicrobial urinary catheters can prevent or delay the onset of CAUTI, but the effect on morbidity is not known. Antibiotic treatment is recommended only in symptomatic infection (bacteremia, pyelonephritis, epididymitis, prostatitis), but systemic antimicrobial treatment of asymptomatic CAUTI is only recommended in the following circumstances; (i) patients undergoing urological surgery or implantation of prosthesis; (ii) treatment may be part of a plan to control nosocomial infection due to a particularly virulent organism prevailing in a treatment unit; (iii) patients who have a high risk of serious infectious complications; and (iv) infections caused by strains causing a high incidence of bacteremia.
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Clinical Characteristics of Prostatic Abscess Treated with Transurethral Resection or Incision and Drainage
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Yun Seok Jung, Jang Chun Woo, Yong Seok Lee, Sung Hak Kang, Chang Hee Han, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2009;4(1):67-71. Published online April 30, 2009
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- "Purpose: To evaluate the clinical presentations of prostatic abscess treated with transurethral resection or incision and drainage. Materials and Methods: We retrospectively assessed the charts of 5 patients with the diagnosis of prostatic abscess and treated with transurethral resection or incision and drainage from January 2008 to March 2009. Factors analyzed included presenting features, predisposing factors, radiologic imaging, bacteriological profile, and treatment. Results: The mean patients' age was 58.8 years. Diabetes mellitus was the most common predisposing factor (40%). Four patients presented lower urinary tract symptoms and fever, and three patients had chill. The mean size of prostatic abscess was 3.82cm and four patients had leukocytosis and pyuria. Abscess was drained by transurethral resection of prostate in three cases, and by transurethral incision and drainage in two cases. There were no postoperative complications with complete abscess resolution in all patients. Conclusions: Transurethral resection or incision and drainage should be considered in a patient with large prostatic abscess, which is not responsive to the appropriate antibiotic therapy."
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Experimental Animal Models of Prostatitis: Limitations and Potential
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Yun Seok Jung, Chang Hee Han, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2008;3(1):10-23. Published online April 30, 2008
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- Prostatitis is a polyetiological inflammation of the prostate gland in men characterized by pelvic pain, irritative voiding symptoms, and sexual dysfunction. Histologically prostatitis is characterized by poly- and mononuclear cell infiltrates (neutrophils, lymphocytes, macrophages and plasma cells) in the stromal connective tissue around the acini or ducts. Prostatitis is an important worldwide health problem in men. The pathogenesis and diagnostic criteria for the condition are obscure, with the result that the development of management programs for this condition has been hindered. Animal model(s) might be useful in elucidating mechanisms involved in the molecular pathogenesis of chronic nonbacterial prostatitis and chronic pelvic pain syndrome. Given that prostatitis might have a multifactorial etiology, several animal models with unique features may prove helpful. This review examines a number of experimental animal models of prostatitis and evaluates their advantages and limitations.
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Role of Alpha Blocker Therapy for Chronic Prostatitis/ Chronic Pelvic Pain Syndrome
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A-Ram Choi, Chang Hee Han
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):136-142. Published online October 31, 2007
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- Prostatitis is a common medical diagnosis. The etiology of this symptomatic syndrome can be an acute or chronic bacterial infection, a noninfectious initiator, or iatrogenic heat or radiation. Alpha-blocker therapy has been advocated, with various levels of evidence, as a treatment modality for all categories of the prostatitis syndromes. From a pharmacological standpoint, the alpha blockers used in urology are not interchangeable. These drugs may work by different mechanisms and with different efficacy in patients with lower urinary tract symptoms related to benign prostatic hyperplasia and in those with symptoms of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). This article reviews the rationale for alpha blockers in patients with CP/CPPS.
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