Urogenital Tract Infection

Volume 16 (3); December 2021

Original Articles

Changes of Antimicrobial Resistance Causing Infections Following Transrectal Prostate Biopsy: Analysis of 10-Year Data: Da Eun Han, Sun Tae Ahn, Jong Wook Kim, Du Geon Moon, Hong Seok Park, Mi Mi Oh; Urogenit Tract Infect 2021;16(3):55-60. Published online December 31, 2021; DOI: https://doi.org/10.14777/uti.2021.16.3.55

Abstract PDF PubReader ePub: Purpose: The production of extended-spectrum β-lactamases (ESBLs) has emerged as one of the main causes of antimicrobial resistance. It is well known that infections of ESBL-producing Enterobacteriaceae causes poor clinical outcomes. This study investigated the changes in the antimicrobial resistance patterns in infections following transrectal ultrasound-guided prostate (TR) biopsy over a 10 year period and analyzed whether the clinical course varies in infections caused by the ESBL-producing Enterobacteriaceae.
Materials and Methods: We retrospectively analyzed patients who had infections after a TR biopsy at the Korea University Guro Hospital from January 2010 to October 2019. Infection from a TR biopsy was defined as readmission due to a fever of 38 degrees or higher that occurred within one week after the biopsy.
Results: Among 1,855 patients who received a TR biopsy, 39 patients (2.10%) had infectious complications. Of 33 culture-positive patients, 29 patients (87.9%) showed quinolone resistance, 10 patients (30.3%) were ESBL-positive and 9 patients had concomitant quinolone resistance and were also ESBL-positive. 75% of ESBL-positive bacterial infections occurred after 2016 indicating increasing incidence in recent days. The only significant difference in the clinical course between the ESBL-negative and the positive group was the lower systolic blood pressure of the ESBL-positive group during hospitalization (p-value=0.018).
Conclusions: Infections due to the ESBL-producing Enterobacteriaceae showed a tendency to increase among TR biopsy patients since 2016. Although the clinical course of the ESBL-positive infection did not show significant differences to ESBL-negative infection, further analysis is needed because of the small number of patients.

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Ureteral Stent Induced Urinary Tract Infection and Microbial Inconsistency Between Bladder and Renal Pelvis: Useok Choi, Eun Jae Kim, Don Hee Lyu, Bong Hee Park, Hong Chung, Chang Hee Han, Sangrak Bae; Urogenit Tract Infect 2021;16(3):61-66. Published online December 31, 2021; DOI: https://doi.org/10.14777/uti.2021.16.3.61

Purpose: This study examined the effects of long-term ureteral stent (US) on urinary tract infection (UTI) by bacterial migration and bacterial colonization.
Materials and Methods: From March 2014 to August 2021, 64 patients who underwent US for more than six months were enrolled in this study. When the US was inserted for the first time and replaced regularly, urine was collected from the bladder and renal pelvis and cultured. Patients’ the characteristics, and differences in pathogens related to US infection were analyzed.
Results: The mean age was 66.4 years, and the mean duration of indwelling was 37.5 months. There were 38 cases (59.3%) by malignant and 26 cases (40.6%) by benign causes. UTI occurred in 33 cases (53%); 16 cases (25%) were hospitalized for febrile UTI. After the initial US insertion, bacteria were identified in the bladder 285 days later and in the renal pelvis after 619 days. The bladder culture was positive in 10 of the 33 patients, and renal pelvis alone was positive in nine of the 33 patients. The same strain was confirmed in the bladder and renal pelvis in 12 cases (18.8%), and it took a mean of 5.8 months ± 6.32 (standard deviation) for the upward migration of bacteria.
Conclusions: UTIs occur in approximately 50% of patients with long-term US indwelling. The probability of culturing the same strain by a US was approximately 18.8%, and the role of pathogen transmission of a US does not appear to be significant. In addition, renal pelvis culture would be helpful in cases of failed bladder antibiotics susceptibility.

Citations

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Comprehensive analysis of the bacterial spectrum for enhanced clinical insight in microbial ureteral stent colonization, uncomplicated urinary tract infections and catheter-associated urinary tract infections: a principal component analysis-based literatu
Matilde Lepori, Olivier Braissant, Gernot Bonkat, Malte Rieken
World Journal of Urology.2024;[Epub] CrossRef

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