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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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Clinical Study According to Presence of Prior Manipulation in Patients with Acute Bacterial Prostatitis
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Kwang Ho Kim, Eu Chang Hwang, Sun Ouck Kim, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Kwang Sung Park
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Korean J Urogenit Tract Infect Inflamm 2012;7(2):172-177. Published online October 31, 2012
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- Purpose: Acute bacterial prostatitis (ABP) is uncommon and proper guidelines concerning antibiotic administration for ABP with urologic procedure are unclear. We retrospectively analyzed clinical symptoms and etiologic organism in ABP according to presence of prior urologic manipulation.
Materials and Methods: The clinical records of 65 patients who had been treated for ABP between January 2007 and December 2011 were reviewed. We analyzed parameters including history taking, physical examination, prior manipulations, antibiotics administration, mean length of treatment, complications, urinalysis, and urine and blood culture. Results were analyzed according to two subgroups; Group 1, those without prior urologic manipulation, and Group 2, those with prior manipulation.
Results: The population of Group 1 was 22 (33.8%) and Group 2 was 43 (66.2%). The mean age of the patients in both groups were 56.5±15.6 years and 64.0±12.5 years, respectively. Of the clinical symptoms in both groups, fever was most common (81.8% and 83.7%). The mean pyuria grades were 2.82±0.37 and 3.47±0.25 each in both groups. In group 2, prostatic biopsy (36, 83.7%) was the most frequent manipulation of the patients. Dysuria and storage symptoms were significantly more frequent in Group 1. The number of diabetes mellitus patients and the admission rates were higher in Group 2. E. coli was the most frequently isolated pathogen from urine and blood (23.1% and 24.6%, respectively). Resistance to ciprofloxacin was very high in group 1 (60.0%) and group 2 (83.3%). However, there was no significant difference between the two groups.
Conclusions: Resistance rates to ampicillin and ciprofloxacin in ABP were very high in all patients. The resistance rates were higher in patients with prior manipulation, but there was no significant difference. When we consider high resistance to ciprofloxacin in ABP, more careful attention should be paid to empirical treatment of ABP patients with prior manipulation. (Korean J UTII 2012;7:172-177)
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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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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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