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Seung Ok Yang 6 Articles
Korean Multicenter Study of Infectious Complications after Transurethral Prostate Surgery in Patients with Preoperative Sterile Urine
Seong Hyeon Yu, Seung Il Jung, Eu Chang Hwang, Tae-Hyoung Kim, Jae Duck Choi, Koo Han Yoo, Jeong Woo Lee, Dong Hoon Koh, Sangrak Bae, Seung Ok Yang, Joongwon Choi, Seung Ki Min, Hoon Choi
Urogenit Tract Infect 2022;17(3):81-88.   Published online December 31, 2022
DOI: https://doi.org/10.14777/uti.2022.17.3.81
AbstractAbstract PDFPubReaderePub
Purpose: To evaluate the efficacy of antibiotic prophylaxis and determine the risk factors of infectious complications after transurethral surgery of the prostate.
Materials and Methods: Seven hundred and seventy-two patients who underwent transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HOLEP) were reviewed. Of these, this study enrolled 643 patients without bacteriuria who had not received antibiotics for urinary tract infections for two weeks before surgery. The patients were divided into two groups according to the duration of the antibiotics (Group 1: less than one day, n=396 vs. Group 2: more than one day, n=247).
Results: The overall incidence of postoperative infectious complications in 643 patients was 5.0% (32/643). When postoperative infectious complications were compared according to the duration of the antibiotics (Group 1 vs. Group 2), the infectious complications rates were 5.6% (22/396) vs. 4.0% (10/247), respectively (p=0.393). When postoperative infectious complications were compared according to the duration of antibiotics (Group 1 vs. Group 2) in the TURP and HOLEP groups, the infectious complications rates were 6.3% (12/192) vs. 1.0% (1/103) (p=0.035) and 4.9% (10/203) vs. 6.0% (8/134) (p=0.677), respectively. The duration of Foley catheterization was independently associated with infectious complications (p=0.003).
Conclusions: The results showed that prolonged postoperative catheterization affects postoperative infectious complications associated with transurethral prostate surgery. Although antibiotics administered for less than one day are effective for antibiotic prophylaxis of transurethral prostate surgery, a longer antibiotic therapy is recommended for TURP.
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Systematic Literature Review of the Urological Field and Considerations in COVID-19
Joongwon Choi, Hyun Soo Ryoo, Jae Hyun Ryu, Yun Beom Kim, Seung Ok Yang, Jeong Kee Lee, Tae Young Jung, Jung Hoon Kim, Tae-Hyoung Kim
Urogenit Tract Infect 2021;16(1):1-7.   Published online April 30, 2021
DOI: https://doi.org/10.14777/uti.2021.16.1.1
AbstractAbstract PDFPubReaderePub
Coronavirus disease 2019 (COVID-19) was declared a worldwide pandemic in March 2020 after originating in China. Widespread uncertainty resulting from the pandemic has revolutionized urology practice worldwide, similar to that observed in other fields. The urological manifestations of COVID-19 were investigated by performing a literature search using a combination of keywords related to COVID-19 and urology. To date, COVID-19 has not been associated with any lower urinary tract symptoms, and there is no level 1 evidence that associates it with urinary malignancy and urolithiasis. Viral RNA has been detected in urine (5.74%), but there is no evidence of actual infection via urine. COVID-19 has transformed the standard urological practice into crisis-based care and has changed the medical and surgical priorities dramatically in the field. Most hospitals have established quarantine guidelines for each hospital, and procedures must be performed according to the present circumstances. Furthermore, in the absence of high-level evidence, specific efforts are needed to minimize the risk of COVID-19 infections during care.
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Management of Candida Urinary Tract Infection in the Elderly
Sang Jin Kim, Jae Hyun Ryu, Yun Beom Kim, Seung Ok Yang
Urogenit Tract Infect 2019;14(2):33-41.   Published online August 30, 2019
DOI: https://doi.org/10.14777/uti.2019.14.2.33
AbstractAbstract PDF
Candida urinary tract infections in elderly patients are becoming increasingly common. The risk factors for the development of candiduria include old age, use of broad-spectrum antibiotics, corticosteroids and indwelling urethral catheters, as well as diabetes mellitus, urological abnormalities, and hematological malignancies. The presence of signs and symptoms of infection are unusual, and the intensity of fungal growth in culture does not correlate with the outcome. Elderly patients often present with atypical signs and symptoms of infection. Careful assessment of the patient’s clinical status should be undertaken before treatment is initiated. The indications for antifungal therapy are the same for older and younger individuals, and the initial antifungal therapy should be selected based on the infecting organism and local epidemiology. Fluconazole is the mainstay of treatment. On the other hand, Candida glabrata is more common in elderly patients and is often refractory to fluconazole therapy. The selection of drug therapy for elderly patients should consider the comorbidities, risk of drug-drug interactions, and dose adjustment for physiological function.
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Infectious Complications after Prostate Biopsy: A Prospective Multicenter Prostate Biopsy Study
Eu Chang Hwang, Ho Song Yu, Seung Il Jung, Dong Deuk Kwon, Sun Ju Lee, Tae-Hyoung Kim, In Ho Chang, Hana Yoon, Bongsuk Shim, Kwang Hyun Kim, Donghyun Lee, Jung-Sik Huh, Dong Hoon Lim, Won Jin Jo, Seung Ki Min, Gilho Lee, Ki Ho Kim, Tae Hwan Kim, Seo Yeon Lee, Seung Ok Yang, Jae Min Chung, Sang Don Lee, Chang Hee Han, Sang Rak Bae, Hyun Sop Choe, Seung-Ju Lee, Hong Chung, Yong Gil Na, Seung Woo Yang, Sung Woon Park, Young Ho Kim, Tae Hyo Kim, Won Yeol Cho, June Hyun Han, Yong-Hyun Cho, U-Syn Ha, Heung Jae Park, The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII)
Urogenit Tract Infect 2016;11(1):17-24.   Published online April 30, 2016
AbstractAbstract PDF
Purpose: Recent studies have highlighted an increasing trend of infectious complications due to fluoroquinolone-resistant organisms among men undergoing transrectal prostate biopsy. This study evaluated the current incidence of infective complications after trans-rectal prostate biopsy for identification of risk factors in Korean men who received fluoroquinolone prophylaxis.
Materials and Methods: A prospective, multicenter study was conducted in Korea from January to December 2015. Prostate biopsies performed with fluoroquinolone prophylaxis during 3 months in each center were included. A pre-biopsy questionnaire was used for identification of patient characteristics. Clinical variables including underlying disease, antibiotic prophylaxis, enema, povidoneiodine cleansing of the rectum, and infectious complications were evaluated. The primary outcome was the post-biopsy infection rate after fluoroquinolone prophylaxis. Univariable and multivariable analyses were used for identification of risk factors for infectious complications.
Results: The study included 827 patients, of whom 93 patients (11.2%) reported receiving antibiotics in the previous 6 months and 2.5% had a history of prostatitis. The infectious complication rate was 2.2%. Post-biopsy sepsis was reported in 2 patients (0.2%). In multivariable analysis predictors of post-biopsy sepsis included person performing biopsy (adjusted odds ratio [OR], 4.05; 95% confidence interval [CI], 1.31-12.5; p=0.015) and operation history within 6 months (adjusted OR, 5.65; 95% CI, 1.74-18.2; p=0.004).
Conclusions: The post-prostate biopsy infectious complication rate in this study was 2.2%. Person performing biopsy (non-urologists) and recent operation history were independent risk factors for infectious complications after trans-rectal prostate biopsy.
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Clinical Data of Urine Culture and Antimicrobial Sensitivity Tests according to the Voiding Method over 15 Years in Patients with Spinal Cord Injury
Won Jun Lee, Sang Jin Kim, Jae Hyun Ryu, Yun Beom Kim, Seung Ok Yang, Jeong Ki Lee, Tae Young Jung
Urogenit Tract Infect 2016;11(1):30-35.   Published online April 30, 2016
AbstractAbstract PDF
Purpose: To analyze the results of urine cultures and antimicrobial sensitivity tests according to the voiding methods in patients with spinal cord injury (SCI) over a 15-year period.
Materials and Methods: A total of 1,579 urine culture samples, obtained from January 2000 to December 2014, for 73 SCI patients were analyzed according to the voiding method. We analyzed the following: positive urine culture rate, colony counts, isolated number of organism, major organisms, and antimicrobial sensitivity tests. The voiding methods were categorized into four methods: clean intermittent catheterization (CIC), suprapubic catheterization (SPC), urethral Foley catheter, and spontaneous voiding (SV).
Results: Among the 1,579 urine samples, 1,250 (79.2%) were positive. The CIC group showed the lowest rate of bacteriuria (p<0.001), colony counts (p<0.001), and polymicrobial infection (p<0.001). Causative organisms were mostly gram-negative bacteria (86.7%). Pseudomonas aeruginosa (22.7%) was most common pathogen followed by Escherichia coli (22.3%), Klebsiella species (9.5%), Providencia species (4.4%), and Serratia marcescens (4.2%). Major pathogens and antimicrobial sensitivity tests were different according to the voiding method.
Conclusions: CIC is the best voiding method to reduce urinary tract infection (UTI) in SCI patients. To treat UTI in in SCI patients, empirical antibiotics can be chosen according to the voiding method based on the reference of our study prior to the availability of antimicrobial sensitivity results.
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Catheter-associated Urinary Tract Infection
Seung Ok Yang
Korean J Urogenit Tract Infect Inflamm 2013;8(2):73-82.   Published online October 31, 2013
AbstractAbstract PDF
Catheter-associated urinary tract infection (CAUTI) is the most commonly occurring nosocomial infection worldwide, accounting for approximately 40% of all hospital acquired infections. A fair number of hospitalized patients undergo insertion of a urinary catheter at some point during their stay, and the use of indwelling urinary catheters appears to be increasing. Instrumentation of the urinary tract is always a high risk factor for CAUTI. A urinary catheter compromises the normal protective mechanisms of the urinary tract and enables bacterial colonization/biofilm formation on the catheter surface. Bacteriuria may progress toward CAUTI, which has been associated with increased morbidity, mortality, hospital cost, and duration of stay. Unfortunately, many physicians are not aware of appropriate indications for use of indwelling urethral catheters as well as accurate criteria for CAUTI. These conditions could result in superfluous catheterization, a potential source of CAUTI, leading to unnecessary use of antimicrobials for treatment of asymptomatic bacteriuria, resulting in emergence of resistant organisms. We discuss the overall view of CAUTI: definition, pathophysiology, pathogenesis, treatment, and prevention, mainly including descriptions associated with the indwelling urethralcatheter.
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