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Antibiotic Prophylaxis and Risk Factors of Infectious Complication after Endourologic Procedures of the Upper Urinary Tract
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Sung Dae Kim, Dong Wan Sohn
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Korean J Urogenit Tract Infect Inflamm 2012;7(2):149-157. Published online October 31, 2012
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- Purpose: We investigated a retrospective analysis of infectious complication and its risk factors after endourologic procedures of the upper urinary tract, focusing on antibiotic prophylaxis (AP).
Materials and Methods: We studied AP in 488 upper urinary tract examinations or treatments.Procedures included ureteral stenting, percutaneous nephrostomy, retrograde pyelography, and diagnostic ureteroscopy. We calculated that the prevalence and kind of AP and the incidence of febrile infectious complications with respect to each procedure and attempted to find the risk factors.
Results: AP was used in 456 (93.3%) cases totally. Antibiotics of quinolone were the most popular medication. There are 17 (3.7%) febrile infectious complication cases after procedure, the most common procedure was percutaneous nephrostomy in 7 cases (6.0%). Bacteriuria, hydronephrosis, whether or not ureteral stent, or nephrostomy, or Foley catheterization was applied prior to examination or treatment, and were independent risk factors for infectious complications (<0.05).
Conclusions: The data suggest that the risks of infectious complications should be evaluated carefully and AP should be recommended according to those risks before the procedures. (Korean J UTII 2012;7:149-157)
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Antimicrobial Effect of Uro-vaxom? in Catheter-Related Urinary Tract Infection
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Sun Wook Kim, Byung Il Yoon, U Syn Ha, Dong Wan Sohn, Yong Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2012;7(2):158-163. Published online October 31, 2012
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- Purpose: Urinary tract infection (UTI) is a relatively common disease, and clinically it appears diversely like urethritis, cystitis, prostatitis, and acute pyelonephritis. E. coli which is the major causative microorganism of UTI, and accounts for 50% of hospital pathogens cultured in 40% of catheter-related UTI. We evaluated the preventive effect on UTI and inhibitory effect on complications of Uro-vaxom?, and investigate the effect of Uro-vaxom? in catheter induced UTI.
Materials and Methods: A comprehensive electronic search was conducted using the Medline database to identify all publications relating to Uro-vaxom? and catheter and UTI by using keywords Uro-vaxom?, catheter, catheterization, urinary tract infection, cystitis, bacteriuria, antimicrobial agents, intensive care unit.
Results: 227 literatures which were consistent with our purposes were searched; we intensively analyzed 26 literatures which were appropriate for our literature. All literature reported antimicrobial effects of Uro-vaxom?.
Conclusions: We identified that Uro-vaxom? had a preventive effect on UTI associated with E. coli to patients who had catheterization. (Korean J UTII 2012;7:158-163)
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Factors of Progression to Chronic Infections from Acute Bacterial Prostatitis
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Byung Il Yoon, Seol Kim, Tae Seung Shin, U-Syn Ha, Dong Wan Sohn, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2011;6(2):178-185. Published online October 31, 2011
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- "Purpose: We conducted a retrospective analysis of acute bacterial prostatitis (ABP) to evaluate the factors of progressing to chronic bacterial prostatitis (CBP) and inflammatory chronic pelvic pain syndrome (CPPS) from ABP. Materials and Methods: The clinical records of 480 cases compatible with a confirmed diagnosis of ABP from five urological centers between 2001 and 2010 were reviewed. We defined chronic infection (CI) as a progression to CBP and inflammatory CPPS after treatment of ABP in admission periods when followed-up at 3 months or more. Results were analyzed according to two groups: recovered without CI (group A, n=428) and developed to CI (group B, n=52). Results: Of the 480 ABP patients, 1.3% (6/480) progressed to CBP and 9.6% (46/480) progressed to inflammatory CPPS. The progression rate of CI was 10.9% (52/480). The factors that affected progress to CI were diabetes, prior manipulation, prostate volume, absence of cystostomy and urethral catheterization (p<0.05). Conclusions: The identification and characterization of influential factors may accelerate the development of preventive, diagnostic and therapeutic strategies for the treatment of CI from ABP."
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Changes in Detection Rate of Causative Organisms in Patients with Urethritis Symptoms and Signs
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Seung Hyuk Yim, Myung Sun Choi, U-Syn Ha, Dong Wan Sohn, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2010;5(2):176-181. Published online October 31, 2010
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- "Purpose: Male urethritis is one of the most common sexually transmitted infections (STIs), but the etiology is still unclear in many cases. We retrospectively studied and compared the detection rate of the causative organisms in patients with urethritis symptoms and signs between 2000 and 2009. Materials and Methods: We reviewed the medical records of 181 patients with urethritis symptoms and signs who had undergone a gram stain, urethral swab culture, multiplex polymerase chain reaction (mPCR) assay in 2000 and 2009 at a single hospital. Changes in detection rate of the causative organisms between 2000 and 2009 were analyzed. Results: The common pathogens in 2009/2000 were Ureaplasma urealyticum (27.40% vs. 13.89%, p=0.025), Mycoplasma species (12.33% vs. 5.56%, p=0.107), Chlamydia trachomatis (10.96% vs. 12.04%, p=0.827) and Neisseria gonorrhoeae (4.11% vs. 1.85%, p=0.367). Detection rate of Ureaplasma urealyticum significantly increased in 2009 compared to 2000 (p=0.025). Conclusions: Ureaplasma urealyticum was the most common pathogen of nongonococcal urethritis in our study. In particular, Ureaplasma urealyticum was found to have increased significantly in recent years."
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The Correlation between Post-void Residual Urine Volume and Urinary Tract Infection in Asymptomatic Men Visited for Prostate Examination
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Seung Hyuk Yim, U-Syn Ha, Dong Wan Sohn, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2010;5(1):63-67. Published online April 30, 2010
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- "Purpose: The large post-void residual urine (PVR) could be related to various complications, especially urinary tract infections (UTIs). Although numerous cut-off value of PVR related to UTIs have been proposed there is still debate on that. We investigated the correlation between PVR and UTIs. Materials and Methods: From January 2008 to December 2008, retrospective analysis was performed on 351 asymptomatic male patients who visited our clinic for prostate examination. The prostate specific antigen (PSA) level, peak urine flow rate, PVR, voided urine volume, International Prostatic Symptom Score (IPSS) and urine culture results were obtained. PVR was measured by portable bladder scanner. A positive result of urine culture was defined as growth of more than 100,000 bacteria per ml. We investigated the association between urine culture results and PVR, and estimated cut-off value of PVR predicting bacteriuria using ROC analysis. Results: The mean age of patients was 63.3±10.4years and 8.83% of the total patients (31 patients) showed positive in urine culture. Mean PVR volume was significantly higher in the group with positive urine culture compare to the group with negative urine culture (105.6mL vs 41.8mL, p<0.001), but we couldn't validate cut-off value of PVR for predicting UTIs. Conclusions: Significant bacteriuria was found in 8.83% of the asymptomatic male patients. Although the positive relationship between PVR and the risk of UTIs was found we couldn't validate cut-off value of PVR for predicting UTIs."
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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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Jaundice and Acute Pyelonephritis due to a Giant Urinoma
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Sung Dae Kim, Dong Sub Lee, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2008;3(2):244-248. Published online October 31, 2008
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- Disruption of the urinary collecting system can produce internalized urine leaks that can be continous urine extravasation and form an encapsulated collection of urine, which is known as a urinoma. Urinoma is also called as pararenal pseudocyst and usually the result of renal injury and may be the result of obstructive uropathy from a ureteral stone or pelvic mass or even a urological procedure. Although urinoma may induce the urinary infection such as acute pyelonephritis, it may not give rise to jaundice due to biliary tract obstruction. We describe an unusual case of jaundice and acute pyelonephritis due to a giant urionoma after high grade renal injury.
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The Antimicrobial Effect of Antibiotics to Patients with Chronic Prostatitis of Positive Reaction on Chlamydial Antibody
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Sung Dae Kim, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2008;3(1):81-88. Published online April 30, 2008
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- "Purpose: Chronic bacterial prostatitis is the most common urological disease in adult males, with antibiotic therapy being the gold standard for its treatment. Recent studies suggest that Chlamydia may play a role in chronic prostatitis but was difficult to prove the pathogen to the prostate. We evaluated the effect of three antibiotics (azithromycin, doxycycline, levofloxacin) in patients with chronic prostatitis of positive reaction on Chlamydial antibody. Material and Methods: The study included 54 patients who had symptoms of chronic prostatitis and proven presence of Chlamydia. The presence of Chlamydia was confirmed in expressed prostatic secretion (EPS) immediately after prostatic massage by multiplex polymerase chain reaction (PCR). The patients were randomized to receive azithromycin 1.0g (n=16) once, or doxycycline 100mg b.i.d. (n=19) for 21 days or levofloxacin 100mg t.i.d. (n=19) for 21 days. Patients’ sexual partners were treated at the same time. Clinical and bacteriological efficacy (leukocyte count, pathogen eradication rate, NIH-CPSI) was evaluated after the end of therapy. Results: After treatment of antibiotics, the leukocytes counts in the EPS was significantly decreased in all groups (p<0.05), but there was no significant difference in three groups. Also, all of groups was superior to control Chlamydia (azithromycin:doxycycline:levofloxacin=93.75%:78.94%:89.47%) and there was no significant difference of the pathogen eradication rates in three groups. The total NIH-CPSI score was significantly decreased, especially pain domain and quality of life domain (p<0.05), and there was no significant difference in three groups. Conclusions: These data suggest that antibiotics of three groups was effective to the patient with chronic prostatitis of positive reaction on Chlamydia antibody."
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The Present Status and Counterplans of Nosocomial Infection
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Sung Dae Kim, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):1-11. Published online May 31, 2007
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- "Although of advances in medical environment we are faced with new pathogen in hospital according to increase of antimicrobial resistance, invasive procedure, population of old men, abuse of immune suppressants. Nosocomial infections are more common phenomena than other infection in clinical practice. Therefore, we should know about the exact definition, diagnostic principles, need of control of nosocomial infection. Especially, We need to understand about it in Korea. So the Korean Society for Nosocomial Infection Control (KOSNIC) organized the Korean Nosocomial Infectious Surveillance System (KONIS) to establish a nationwide database of nosocomial infection rate on the intensive care units of hospitals in Korea. This article focuses on the definition, background, principles of diagnosis, the current status and counterplans of nosocomial infection in Korea. We have full assurance that it should provide a theoretical strategy to enforce the infection control."
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The Relationship between Sexually Transmitted Diseases and HIV Transmission
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Sung Dae Kim, Dong Wan Sohn, Seung-Ju Lee, Sae Woong Kim, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):157-166. Published online October 31, 2007
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- More than 42 million people worldwide are now infected with HIV, in spite of sustained prevention activities. Although the spread of HIV has been primarily sexual, epidemiological studies have indicated that the efficiency of the spread of HIV is poor, perhaps as infrequently as 1 in every 1,000 episodes of sexual intercourse. However, sexually transmitted diseases (STDs) that cause ulcers or inflammation greatly increase the efficiency of HIV transmission by increasing both the infectiousness of, and the susceptibility to HIV infection. STDs might be particularly important in the early stages of a localized HIV epidemic, when people with risky sexual behaviour are most likely to become infected. In China, eastern Europe and Russia, there has been a remarkable increase in the incidence of STDs in recent years, and this is reflected in the rapid increase in the spread of HIV in these areas. Targeted STDs detection and treatment should have a central role in HIV prevention in these emerging epidemics.
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Bilateral Vesicoureteral Reflux and Wilms' Tumor Combined with Urinary Tract Infection
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Byung Il Yoon, Sung Dae Kim, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):221-224. Published online October 31, 2007
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- Vesicoureteral reflux is a common condition in children. It may cause and maintain urinary tract infection, evaentually leading to progressive renal damage and end-stage renal disease. Wilms' tumor is the most common primary malignant renal tumor of childhood. There is no literature that vesicoureteral reflux combined with Wilms' tumor. We report rare case of bilateral vesicoureteral reflux combined with left Wilms' tumor.
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