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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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- 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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