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Changes of Antimicrobial Resistance Causing Infections Following Transrectal Prostate Biopsy: Analysis of 10-Year Data
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Da Eun Han, Sun Tae Ahn, Jong Wook Kim, Du Geon Moon, Hong Seok Park, Mi Mi Oh
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Urogenit Tract Infect 2021;16(3):55-60. Published online December 31, 2021
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DOI: https://doi.org/10.14777/uti.2021.16.3.55
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Abstract
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- Purpose: The production of extended-spectrum β-lactamases (ESBLs) has emerged as one of the main causes of antimicrobial resistance. It is well known that infections of ESBL-producing Enterobacteriaceae causes poor clinical outcomes. This study investigated the changes in the antimicrobial resistance patterns in infections following transrectal ultrasound-guided prostate (TR) biopsy over a 10 year period and analyzed whether the clinical course varies in infections caused by the ESBL-producing Enterobacteriaceae.
Materials and Methods: We retrospectively analyzed patients who had infections after a TR biopsy at the Korea University Guro Hospital from January 2010 to October 2019. Infection from a TR biopsy was defined as readmission due to a fever of 38 degrees or higher that occurred within one week after the biopsy. Results: Among 1,855 patients who received a TR biopsy, 39 patients (2.10%) had infectious complications. Of 33 culture-positive patients, 29 patients (87.9%) showed quinolone resistance, 10 patients (30.3%) were ESBL-positive and 9 patients had concomitant quinolone resistance and were also ESBL-positive. 75% of ESBL-positive bacterial infections occurred after 2016 indicating increasing incidence in recent days. The only significant difference in the clinical course between the ESBL-negative and the positive group was the lower systolic blood pressure of the ESBL-positive group during hospitalization (p-value=0.018). Conclusions: Infections due to the ESBL-producing Enterobacteriaceae showed a tendency to increase among TR biopsy patients since 2016. Although the clinical course of the ESBL-positive infection did not show significant differences to ESBL-negative infection, further analysis is needed because of the small number of patients.
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Unexpected Septic Shock after Ureteroscopic Lithotripsy in a Patient Preoperatively Treated for a Urinary Tract Infection
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Jong Wook Kim, Hyoung Kook Jeong, Jong Jin Park, Ji Yun Chae, Hong Seok Park, Du Geon Moon, Mi Mi Oh
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Urogenit Tract Infect 2016;11(2):66-68. Published online August 31, 2016
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- We describe a case of life-threatening septic shock after ureteroscopic lithotripsy. Prior to surgery, the patient had a confirmed sterile urine culture posttreatment for a urinary tract infection due to extended spectrum beta-lactamase-positive Escherichia coli.
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Renal Actinomycosis Initially Misdiagnosed as Renal Cell Carcinoma with Renal Vein Thrombosis
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Jong Wook Kim, Hyoung Kook Jeong, Jong Jin Park, Ji Yun Chae, Hong Seok Park, Du Geon Moon, Mi Mi Oh
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Urogenit Tract Infect 2016;11(2):73-75. Published online August 31, 2016
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- This case report describes an uncommon case of renal actinomycosis in a 63-year-old man. The patient underwent radical nephrectomy for suspicious renal cell carcinoma with renal vein thrombosis and spinal metastasis. The postoperative diagnosis of renal and spinal actinomycosis was established in accordance with the results from histological examination. Three years after surgery, the patient did not show any symptoms of recurrence.
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Changes of Bacterial Resistant Pattern in Adult Acute Epididymitis at a Tertiary Hospital in Recent Ten Years
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Jong Jin Park, Jong Wook Kim, Jae Hyun Bae, Du Geon Moon, Mi Mi Oh
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Korean J Urogenit Tract Infect Inflamm 2014;9(1):39-43. Published online April 30, 2014
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We conducted a retrospective study to investigate causative bacteria of adult epididymitis and their characteristics and resistance in the recent 10 years at a tertiary hospital. Materials and Methods: We reviewed the medical records of 121 patients who were diagnosed with acute epididymitis from 2002 to 2012. Diagnosis was based on symptoms, physical examination, and ultrasonography. We analyzed causative organisms and changes of antibiotic resistance pattern according to time course in the recent 10 years. Results: The most commonly detected bacteria were Pseudomonas aeruginosa and Escherichia coli. Fluouroquinolone resistance has emerged since 2006 and 50% of the patients have resistance to fluouroquinolones. Conclusions: Quinolone resistance composes a major proportion of the causative organism. Therefore, while according to the guidelines, fluoroquinolone may be the first response for elderly men, we recommend that antibiotic resistance should be considered if fever persists, and other antibiotics could be included.
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Spinal Cord Injury and Urinary Tract Infection
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Min Gu Park, Du Geon Moon
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):150-158. Published online October 31, 2009
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- Urinary tract infection (UTI) is the most frequently reported secondary impairment in individuals with spinal cord lesion (SCI). UTI is responsible for major morbidiry and mortality in SCI patients. Due to chronic bacterial infection within biofilms, an antibacterial treatment based on a urinary culture of bacteria in the urine and its antimicrobial susceptibility may fail to eradicate catheter associated UTI. The classic symptoms of UTI are unreliable indicators in SCI patients with neurogenic bladder. It is widely accepted that intermittent catheterization, when compared with indwelling catheters, reduces the risk of UTI in SCI patients and is the preferred method of bladder drainage in SCI patients. Guidelines for selecting antimicrobial agents in SCI patients are similar to guidelines for the treatment of complicated UTI in the general population.
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Pyoderma Gangrenosum of the Penis
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Young Dae Bae, Seung Min Jeoung, Hong Jae Ahn, Ji Yoon Chae, Ki Won Ko, Sang Gan Nam, Du Geon Moon
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Korean J Urogenit Tract Infect Inflamm 2009;4(1):108-111. Published online April 30, 2009
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- Pyoderma gangrenosum is a rare ulcerating inflammatory skin disease. Genital involvement has been rarely reported. We report a 45-year-old man with penile pyoderma gangrenosum who was treated with partial penectomy.
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The Relationship between Sexually Transmitted Diseases and Male Infertility
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Myeong Heon Jin, Du Geon Moon
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):151-156. Published online October 31, 2007
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- Infections of the male accessory glands are potentially correctable causes of male infertility. But sexually transmitted pathogens generally have not been considered to be an important environmental determinant of male infertility except for obstruction of the epididymis or vas deferens. Despite the recent reports of several micro-organisms such as Chlamydia trachomatis and Mycoplasmataceae, evidences are still lacking to confirm the negative influence of sexually transmitted diseases on sperm quality. To establish the effect of sexually transmitted disease on male infertility, further studies with control group based on exact diagnostic criteria are requested.
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Characteristics of Recent 10 Cases of Fournier's Gangrene
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Myeong Heon Jin, Mi Mi Oh, Jae Hyun Bae, Hong Soek Park, Duck Ki Yoon, Du Geon Moon
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Korean J Urogenit Tract Infect Inflamm 2007;2(2):203-208. Published online October 31, 2007
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- "Purpose: Fournier’s gangrene is a rare and potentially fatal infectious disease characterized by necrotic fasciitis of the perineum and abdominal wall, along with the scrotum and penis in men and the vulva in women. The aim of this study is to share our recent experience with the management of this difficult infectious disease. Materials and Methods: The authors reviewed retrospectively the clinical records of a series of 10 patients with Fournier’s gangrene between the years 2004 and 2007 who, after initial treatment. The patient’s age, predisposing etiological factors, interval between onset of symptoms and diagnosis, lesion site, results of bacteriologic cultures, treatment and reconstructive procedures, length of hospital stay, treatment and outcome were analyzed. Results: The patients' ages ranged between 46 and 84 years (mean 59 years). Of the 10 patients, 1 (10%) died and 9 (90%) survived. The predisposing factors included diabetes mellitus (10 cases, 100%), hypertention (3 cases, 30%), liver cirrhosis (2 cases, 20%), CVA (1 case, 10%). All 10 patients had positive culture results, with 9 (90%) of these being polymicrobial. The most common organisms isolated were Escherichia coli (n=6), Staphylococcus aureus (n=4) and Streptococcus agalactiae (n=2). The important finding wass the fact that quinolone-resistant extended spectrum beta-lactamase (ESBL) Escherichia coli (E. coli) was detected in two cases (20%). The mean length of hospital stay was 41.1 days (7-70). Conclusions: There is no differences between current study and previous, butit is important that ESBL producing E. coli was appeared. It may have influence on length of hospital stay and wound healing. However, more studies are required to conclusively prove the effect of ESBL on prognosis of Fournier’s gangrene."
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