Urogenital Tract Infection

Microbiome Analysis Using Next-Generation Sequencing in Urinary Tract Infections: Hyunho Han, Joo Yong Lee; Urogenit Tract Infect 2022;17(1):1-7. Published online April 30, 2022; DOI: https://doi.org/10.14777/uti.2022.17.1.1

Abstract PDF PubReader ePub: In recent decades, the understanding of the genetic information of microbes and hosts has advanced considerably with the development of next-generation sequencing (NGS). For infectious diseases, genomic analysis can provide valuable information on the host disease susceptibility, microbial pathogenicity, and drug sensitivity. For urinary tract infections (UTI), NGS can reveal the pathogenic microbe and the dysbiosis of the urinary microbiome, which is a crucial factor in the pathogenesis of UTI and other urinary tract disorders. This review outlines the role of urinary microbiome dysbiosis in UTI, urinary stone disease, and cancer. Furthermore, the recent advances in NGS technologies for future applications in infectious disease research are described in detail.

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The Effects of Short-Chain Fatty Acids in Urological Diseases: Hee Jo Yang, Doo Sang Kim; Urogenit Tract Infect 2022;17(1):8-13. Published online April 30, 2022; DOI: https://doi.org/10.14777/uti.2022.17.1.8

Abstract PDF PubReader ePub: The gut microbiome, believed to serve as a second genome within the human body, is involved in the regulation of several metabolic processes. These include human gene expression, development, nutrition and homeostasis. Dysbiosis, is an imbalance in the gut microbiome, which is known to be associated with various disease conditions such as Crohn's disease and Clostridium infections. The gut microbiota communicates with the host through a variety of biomolecules, nutrient signal-independent pathways, and epigenetic mechanisms. The gut microbiota supports the digestion and absorption of food, metabolizes fiber into bioactive short-chain fatty acids (SCFA), produces vitamins and nutrients, maintains gut integrity, and modulates host immunity. Among the above, there has been great interest in SCFA in microbiome research due to its beneficial effects on the intestinal barrier function and systemic anti-inflammatory effects. Recent reports have also indicated the role of SCFA in obesity, insulin resistance, and type 2 diabetes. While SCFA are associated with reduced risk of various diseases, dysbiosis and altered SCFA fermentative pathways could result in disease. This article is a review on the role of SCFA in urological diseases.

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Stone-Free Rates of mPCNL, PCNL, and RIRS: A Systematic Review and Network Meta-Analysis: Dong Hyuk Kang, Kang Su Cho, Doo Yong Chung, Won Sik Jeong, Hae Do Jung, Do Kyung Kim, Joo Yong Lee; Urogenit Tract Infect 2022;17(1):14-25. Published online April 30, 2022; DOI: https://doi.org/10.14777/uti.2022.17.1.14

Abstract PDF PubReader ePub: Purpose: Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are performed to treat renal stones, and miniature PCNL (mPCNL) is used as an alternative to conventional PCNL. We conducted a systematic review of published studies regarding RIRS, PCNL, and mPCNL and performed network meta-analysis on successful outcome (stone-free) rates.
Materials and Methods: The PubMed and EMBASE databases were searched up to December 2020. Data extraction formats were used to extract data on successful outcome rates, study designs, numbers of subjects and characteristics, and methods used to treat renal stones (i.e., RIRS, PCNL, or mPCNL).
Results: Data obtained by 25 studies were used to compare the stone-free rates of RIRS, PCNL, and mPCNL; six comparisons of PCNL and mPCNL, seven of mPCNL and RIRS, and 12 of RIRS and PCNL were analyzed. No difference was found between the stone-free rates of PCNL and mPCNL (odds ratio [OR]: 0.96; 95% confidence interval [CI]: 0.51-1.9) by network meta-analysis. However, the stone-free rate of RIRS was lower than that of mPCNL (OR: 0.41; 95% CI: 0.021-0.82) and PCNL (OR: 0.43; 95% CI: 0.22-0.82). Ranking analysis ranked mPCNL as No. 1 and PCNL as No. 2.
Conclusions: PCNL and mPCNL had better stone-free rates than RIRS for the treatment of renal stones, but the treatment outcomes of PCNL and mPCNL were no different.

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Antibiotic Sensitivity of Bacterial Strains from Prostate Abscess Pus Aspirated Using Ultrasound Guidance: Kyung Kgi Park, Sung Dae Kim, Young-Joo Kim, Jung-Sik Huh; Urogenit Tract Infect 2022;17(1):26-30. Published online April 30, 2022; DOI: https://doi.org/10.14777/uti.2022.17.1.26

Abstract PDF PubReader ePub: Purpose: A prostate abscess is a rare occurrence often caused by immune dysfunction. The diagnostic modality for a prostate abscess is computed tomography or transrectal ultrasound. Transrectal ultrasound-guided aspiration is one such method. If treatment is dependent on the abscess size. This study examined the bacterial strains drained under transrectal ultrasound and their antibiotic sensitivity.
Materials and Methods: The medical records of eight patients diagnosed with a prostatic abscess and treated by transrectal ultrasound-guided aspiration from March 2009 to December 2020 were reviewed retrospectively. The general characteristics, associated diseases, and bacterial strains and their antibiotic sensitivities were identified in blood, urine, and pus cultures.
Results: Eight patients were hospitalized. The average age was 59.5±6.05 years, and the average length of hospitalization was 16.88±5.49 days; 75% had diabetes. No patients had catheterization, spinal injury, or prostate biopsy prior to diagnosis. The mean prostate volume was 47.05±27.3 ml, and the mean prostate abscess size was 2.08±0.83 ml. Under transrectal ultrasonography, the prostate abscess size was 5.43±5.31 ml, and catheters were inserted for treatment in four cases (50%). In the abscess culture test, Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus were found in four, three, and one case, respectively. E. coli and K. pneumoniae responded well to amikacin treatment, while seven cases responded well to Piperacillin/Tazobactam treatment.
Conclusions: Prostate abscesses occur mainly in diabetic patients. The most common cultures are E. coli and K. pneumoniae. Intravenous injection of amikacin or Piperacillin/Tazobactam may be helpful as a treatment prior to bacterial identification.

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