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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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 Abstract
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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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Antimicrobial Prophylaxis in Transurethral Enucleation and Resection of the Prostate: A Comparison of 1-Day Treatment and More than 2-Day Treatment
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Min Seok Kim, Won Jin Cho, Seung Baik, Dong Hoon Lim, Joon Nho, Chul Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2014;9(2):104-110. Published online October 31, 2014
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- Purpose
To evaluate the efficacy of 1-day treatment of antimicrobial prophylaxis by analysis of the incidence and risk factors for postoperative infectious complications such as bacteriuria and urinary tract infection in the transurethral enucleation and resection of the prostate (TUERP). Materials and Methods: A retrospective review of 78 patients who underwent TUERP was performed. Of 78 patients, 32 patients received antibiotics less than 1 day (group A). The other 46 patients received antibiotics for more than 2 days (group B). All patients had urinalysis and urine culture preoperatively, on the day of removal, at 1-2 weeks and 3-4 weeks after discharge. The incidence and the risk factors for postoperative infectious complication were investigated. Results: The incidence of infectious complications after TUERP was not statistically significant between group A and group B (18.8% vs. 15.2%, p=0.680). Multivariate analysis documented only two independent risk factors of postoperative infectious complications: preoperative catheterization (OR, 4.189; 95% CI, 1.071-16.382; p=0.040) and diabetes mellitus (DM) (OR, 5.589; 95% CI, 1.469-21.256; p=0.012). Comparative analysis performed in subgroups with two risk factors also showed no difference in the incidence of infectious complication regardless of antibiotic duration. Conclusions: No significant difference in the incidence of postoperative infectious complications was observed between two groups. Therefore, it seems reasonable to prescribe prophylactic antibiotics less than 1 day for reducing postoperative infectious complications after TUERP. Preoperative urethral catheterization and DM were identified as significant risk factors for postoperative infectious complications and preventive management directed against the risk factors preoperatively is recommended.
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Multidrug Resistance in Neisseria gonorrhoeae
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Seung Baik, Dong Hoon Lim
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Korean J Urogenit Tract Infect Inflamm 2013;8(2):90-97. Published online October 31, 2013
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- Gonorrhea, caused by Neisseria gonorrhoeae is the second most prevalent bacterial sexually transmitted infection. The disease causes serious reproductive complications such as pelvic inflammatory disease, ectopic pregnancy, and infertility, and can facilitate human immunodeficiency virus transmission. Numerous antimicrobial agents have been used for the treatment of gonorrhea since sulfanilamides were introduced in 1936. Unfortunately, N. gonorrhoeae readily develops resistance to antimicrobial agents. Strains with decreased susceptibility to oral third generation cephalosporin (cefixime) are currently emerging. The US Centers for Disease Control and Prevention (CDC) no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections, but recommends combination therapy with ceftriaxone 250 mg intramuscularly an deither azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days as the most reliably effective treatment for uncomplicated gonorrhea.
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Malakoplakia in the Urinary Bladder
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Seung Baik, Chul Sung Kim, Dong Hoon Lim
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Korean J Urogenit Tract Infect Inflamm 2013;8(2):125-128. Published online October 31, 2013
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Malakoplakia is a rare chronic granulomatous disease, which was originally described in the urinary bladder, but can involve many other organs and soft tissues. Malakoplakia is often associated with immunosuppression or immunodeficiency and is believed to be caused by an alternation in the bacterial phagocytic system. Histologically, the presence of Michaelis-Gutmann bodies is pathognomonic. We report on a case of malakoplakia of the bladder in a 62-year-old female.
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Systemic Candidiasis in Patient with Urinary Stone
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Hyoung Sang Kim, Ja Ok Kim, Dong Hoon Lim, Jun Rho, Chul Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2010;5(1):82-86. Published online April 30, 2010
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- Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. Invasive candidiasis accounts for up to from 15 to 30% of all nosocomial infections in critically ill patients. Management of these severe infections has been challenging due to a lack of rapid and reliable diagnostic methods, leading to delay in initiating appropriate antifungal therapy. We report a case of 63 year-old male suggesting right acute pyelonephritis with upper ureteral stone and finally identified systemic candidiasis invading to both eyes.
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Prostatic Tuberculosis with Painless Gross Hematuria
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Cheol Ho Park, Yoon Il Kang, Dong Hoon Lim, Jun Rho, Chul Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):220-223. Published online October 31, 2009
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- Genitourinary tuberculosis contributes to 10-14% of extrapulmonary tuberculosis. The most common site of genital tuberculosis is the epididymis. Prostate tuberculosis is uncommon and is usually found incidentally following transurethral resection. A 78 year old man was admitted to our hospital with painless gross hematuria. Urine culture and cytology was negative, but serum prostate specific antigen was 29.7 ng/ml. Prostate biopsy demonstrated prostatitis and nodular hyperplasia. Transurethral prostatectomy was performed and histology revealed prostate tuberculosis.
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The Value of Transrectal Ultrasonography Guided Needle Aspiration in Prostate Abscess
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Dae Eun Shin, Dong Hoon Lim, Hyung Yoon Moon, Jun Rho, Chul Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):197-202. Published online October 31, 2007
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- "Purpose: To evaluate the feasibility and effectiveness of transrectal ultrasonogram guided needle aspiration and drainage of prostatic abscess. Material and Methods: From January, 2005 to June, 2007, six patients who were diagnosed as prostate abscess and treated in Chosun University Hospital were examined. Assessment parameters included associated disease, symptoms, analysis of midstream urine, blood, and aspirated abscess for leukocyte and common pathogen, digital rectal examination, transrectal sonography, and abdomen-pelvic CT. Managment of prostatic abscess included broad-spectrum antibiotics with or without transrectal ultrasonogram guided needle aspiration. During the follow up, transrectal ultrasound examination and abdomen-pelvic CT, urine analysis and urine culture were performed on an outpatient basis. Result: For all patients, antibiotic therapy and suprapubic cystostomy were performed. Of six patients, four patients received transrectal ultrasonogram guided needle aspiration additionally. One patient was treated by transrectal ultrasonogram guided needle aspiration after the initial treatment of transurethral incision of the prostate was failed. All patients were treated effectively without complications. Conclusion: It is suggested that transrectal ultrasonogram guided needle aspiration is relatively safe and has high success rates regardless of the size, number, and location of abscess."
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Renal Tuberculosis Mimicking Abscess in Calyceal Diverticulum
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Dong Hoon Lim, Yun Il Kang, Hyung Yoon Moon, Joon Rho, Chul Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2007;2(1):96-99. Published online May 31, 2007
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- Renal tuberculosis is a rare disease, which can be easily misdiagnosed. Radiologically the following conditions may mimic renal tuberculosis: chronic pyelonephritis, papillary necrosis, medullary sponge kidney, calyceal diverticulum, renal carcinoma and xanthogranulomatous pyelonephritis. A 27 year old woman presented with recurrent episodes of urinary frequency and intermittent febrile sensation. Laboratory studies for genitourinary tuberculosis showed negative results. Excretory urography and abdominal CT scan revealed the finding of abscess in cealyceal diverticulum in the right kidney. Under the clinical diagnosis of an abscess in calyceal diverticulum, right partial nephrectomy was performed. The pathologic diagnosis revealed renal tuberculosis. We report a case of renal tuberculosis mimicking abscess in calyceal diverticulum.
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