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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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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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