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Risk Factors of Infectious Complications after Transurethral Prostate Surgery in Patients with Preoperative Sterile Urine
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Eu Chang Hwang, Seong Hyeon Yu, Jong Beom Kim, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Kwangsung Park
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Korean J Urogenit Tract Infect Inflamm 2013;8(1):27-31. Published online April 30, 2013
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- Purpose: To determine the risk factors of infectious complications after transurethral surgery of the prostate in patients with sterile urine.
Materials and Methods: A total of 183 patients who underwent transurethral resection of the prostate or holmium laser enucleation of the prostate were reviewed. All patients had urinalyses and urine cultures preoperatively, on the day of catheter removal, and at two weeks postoperatively. Patients were divided into two groups according to whether preoperative urinalysis showed sterile urine (group I, n=99) or not (group II, n=84). Clinical parameters were compared between the two groups. Univariate and multivariate logistic regression were used for estimation of infectious complications after surgery in group I.
Results: Compared with group II, group I showed younger age, fewer post voided residuals, low prostate specific antigen levels, short-term duration of oral antibiotic therapy, and low incidence of infectious complications (p＜0.05). In univariate analysis in group I, age, diabetes mellitus (DM), prostate volume, resection weight, and duration of oral antibiotic therapy showed an association with infectious complications (p＜0.05). Factors showing independent association with infectious complications in group I were DM (odds ratio [OR], 7.31; 95% confidence interval [CI], 1.83-29.0; p=0.005), resection weight (OR, 1.03; 95% CI, 1.01-1.06; p=0.039), and duration of oral antibiotics (OR, 0.64; 95% CI, 0.43-0.94; p=0.025).
Conclusions: Kinds of antibiotics showed no effect on infectious complication, therefore, second generation cephalosporin is recommended for reduction of antibiotic resistance. Clinicians should be aware of the high risk for infectious complication in patients with DM and who underwent large volume resection of the prostate.
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Prophylactic Effectiveness of Second Generation Cephalosporin According to Prostatic Operation Methods
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Seong Woong Na, Eu Chang Hwang, Seung Il Jung, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu
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Korean J Urogenit Tract Infect Inflamm 2011;6(2):171-177. Published online October 31, 2011
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- "Purpose: There is no definitive standard concerning the use of prophylactic antibiotics for prostatic operations, except for transurethral resection of prostate (TUR-P). This study prospectively investigated the prophylactic effectiveness of a second generation cephalosporin according to prostatic operation method. Materials and Methods: From October 2010 to January 2011, prostatic operations were conducted for 67 patients: group I (radical prostatectomy, n=18), group II (TUR-P, n=38), group III (laser TUR-P, n=11) for 11: group III). Prophylactic antibiotics were intravenously administered beginning 1 hour preoperatively and orally with several days postoperatively. Prophylactic effectiveness was evaluated by comparison of urine analysis and presence of bacteriuria. Results: In group I, no patient had preoperative Foley catheter installation, and mean antibiotic prescription period pre- and post-operatively was 5.83 days and 6.94 days. Five group I patients (27.8%) displayed bacteriuria. In group II, 9 patients had preoperative Foley catheter installation and mean antibiotic prescription period was 3.76 days and 5.68 days, respectively. Five patients (13.2%) had postoperative bacteriuria; two in preoperative catheterized patients and three in preoperative non-catheterized patients. In group III, mean antibiotic prescription period was 1.73 days and 5.09 days, respectively. There was no postoperative bacteriuria. Conclusions: Prophylactic use of a second generation cephalosporin for prostatic operation, except laser TUR-P, was limited in preventing postoperative pyuria with bacteriuria. There was a tendency of higher occurrence of postoperative bacteriuria in patients with preoperative Foley catheter installation."
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Clinical Features of Bacteremia Caused by Ciprofloxacin-Resistant Bacteria after Transrectal Ultrasound-Guided Prostate Biopsy
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Bo Sung Shin, Eu Chang Hwang, Seung Il Jung, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu, Jin Woong Kim
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Korean J Urogenit Tract Infect Inflamm 2011;6(1):61-66. Published online April 30, 2011
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- "Purpose: Fluoroquinolone is considered the prophylactic antibiotic of choice for Transrectal ultrasound (TRUS)-guided biopsy. However, failure of quinolone prophylaxis due to emerging quinolone-resistant enterobacteriae has been increasing. We reviewed bacteremia cases after TRUS-guided biopsy to identify antibiotic-resistant bacterial strains with the objective to prevent urosepsis. Materials and Methods: A total of 2,348 patients underwent TRUS-guided biopsy at our institution between January 2004 and December 2009. All patients received intravenous ciprofloxacin for prophylaxis. We retrospectively evaluated patients who developed infectious symptoms, such as fevers and chills. Results: Eleven (0.4%) of 2,348 patients developed infectious symptoms. Escherichia coli was the pathogen responsible for post-biopsy infections occurring in a; 11 (100%) patients with positive blood cultures, which confirmed ciprofloxacin-resistant E. coli, with one isolate producing extended-spectrum beta lactamase. Ten out of 11 E. coli isolates (91%) were resistant to ampicillin and 9 of 11 E. coli isolates (82%) were resistant to gentamicin. Ten out of 11 E. coli isolates (91%) were susceptible to third generation cephalosporins. All such patients were admitted to the hospital and treated with a third generation cephalosporin. One patient who habored an E. coli isolate producing extended-spectrum beta-lactamase received imipenem. Conclusions: Ciprofloxacin is effective in reducing infectious complications. However, recently, bacteremiccases are increasing due to ciprofloxacin resistant E. coli. For patients with infectious symptoms after transrectal prostate biopsy, early antibiotics change, including third generation cephalosporins, are recommended to prevent urosepsis."
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Fournier’s Gangrene: Six Years of Experience with 33 Patients and Validity of the Fournier’s Gangrene Severity Index Score in Korean Patients
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Eu Chang Hwang, Seong Woong Na, Young Jung Kim, Jun Seok Kim, Sun-Ouck Kim, Seung Il Jung, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu, Lu Ji Wan
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Korean J Urogenit Tract Infect Inflamm 2010;5(2):199-206. Published online October 31, 2010
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- "Purpose: To identify predictive factors of survival in patients with Fournier’s gangrene (FG), and to determine the validity of the Fournier’s Gangrene Severity Index Score (FGSIS) in Korean patients. Materials and Method: Thirty-three patients with FG were enrolled. Data were collected regarding medical history, symptoms, physical examination findings, admission laboratory tests, and the extent of body surface area involved (%). The FGSIS, which was developed to assign a numerical score that describes the disease acuity, was used in our study. The data were assessed based on whether or not the patient had survived. Results: Of the 33 patients, 16 survived (48.5%, Group I) and 17 died (51.5%, Group II). Isolated FGSIS and admission laboratory parameters that were statistically different in the two groups included heart rate (p=0.009), white blood cell count (WBC; p=0.035), and serum calcium (p=0.001). The mean body surface area in Group II was statistically different from that of Group I (6.4% vs. 2.4%, p=0.001). The mean FGSIS for groups I and II was 6.6±3.7 and 8.2±4.1, respectively (p=0.26). Based on univariate regression analysis, disease severity had no correlation with the FGSIS. However, isolated parameters, including heart rate, WBC count, serum total calcium level, and the extent of body surface area involved was associated with disease severity. Conclusions: Although the FGSIS was not shown to be a predictive factor for disease severity, metabolic parameters and the extent of body surface area involved appeared to be important factors for predicting FG severity."
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Pyeloureteritis Cystica accompanied by Nonfunctioning Kidney
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Jun Back Park, Chang Min Im, Seung IL Jung, Chan Choi, Taek Won Kang, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):224-227. Published online October 31, 2009
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- Pyeloureteritis cystica is a rare cystic disease formed in the mucosa or submucosa of the renal pelvis and ureter caused by chronic inflammation and irritation, and characterized by multiple filling defects noted on the contrast imaging. The clinical course is usually slow, but manifests if the lesionscause infection or obstruction. Stones are further complication to the disease. We report a case of 69-year-old woman with right flank pain, who had an pyeloureteritis cystica withnonfunctioning kidney caused by proximal ureter stone. The diagnosis was made after nephroureterectomy, followed by pathologic examination.
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Retroperitoneal Fibrosis with Spontaneous Subcapsular Renal Hemorrhage Treated with Medical Thearpy
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Eu Chang Hwang, Ho Suck Chung, Chang Min Im, Seung Il Jung, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu, Jun Eul Hwang1
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Korean J Urogenit Tract Infect Inflamm 2009;4(1):86-88. Published online April 30, 2009
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- Spontaneous subcapsular renal hemorrhage is relative uncommon. The literature suggests that the majority causes for this phenomenon associated with disease of the kidney, blood vessel disease, blood dyscrasia. We report a unique case of retroperitoneal fibrosis combined with subcapsular renal hemorrhage. The patient was successfully treated with medical therapy.
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Bacteremia Caused by Acinetobacter Baumannii during the Treatment of Staghorn Calculi
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Seung Il Jung, Kyung-Chul Son, Taek Won Kang, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu
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Korean J Urogenit Tract Infect Inflamm 2008;3(1):116-119. Published online April 30, 2008
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- Acinetobacter baumannii, a gram-negative, ubiquitous bacteria present in the soil, water and on the skin surface of human beings and animals, is responsible for bronchopneumonia and bacteremia in immuno- compromised and severely illed people, but rarely represents a problem in healthy individuals. We report a case of bacteremia due to Acinetobacter baumannii in a 45-year-old women who underwent percutaneous nephrolithotomy for staghorn calculi.
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