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Tommaso Cai, Paolo Verze, Alessandro Palmieri, Mauro Gacci, Paolo Lanzafame, Gianni Malossini, Gabriella Nesi, Gernot Bonkat, Florian M E Wagenlehner, Vincenzo Mirone, Riccardo Bartoletti, Truls E Bjerklund Johansen
OBJECTIVES: To evaluate whether it is always necessary to test for the presence of asymptomatic bacteriuria (AB) in patients undergoing urological surgical procedures and if present, to treat AB with antimicrobial prophylaxis. METHODS: All patients who underwent urological surgical procedures from December 2008 to October 2013 in a tertiary referral urological center were considered for this study. All patients received antimicrobial prophylaxis in line with European Association of Urology (EAU) guidelines on urological infections...
October 20, 2016: Urology
David Eldred-Evans, Veeru Kasivisvanathan, Fahd Khan, Mieke Van Hemelrijck, Alexander Polson, Peter Acher, Richard Popert
PURPOSE: Systematic transrectal ultrasound biopsies have been the first-line biopsy strategy in men with suspected prostate cancer for over 30 years. Transperineal biopsy is an alternative approach but has been predominately reserved as a repeat biopsy strategy and not widely used as a first-line approach. This study evaluates the diagnostic and clinical outcomes of transperineal sector biopsy (TPSB) as a first-line biopsy strategy in the diagnosis and management of prostate cancer. MATERIALS AND METHODS: A multi-institutional review of 402 consecutive patients who underwent primary transperineal sector biopsy...
October 10, 2016: Urology Journal
Fatehi Elnour Elzein, Mohammed Alsaeed, Sulafa Ballool, Ashraf Attia
The mortality in Strongyloides hyperinfection syndrome (SHS) is alarmingly high. This is particularly common in bone marrow, renal, and other solid organ transplant (SOT) patients, where figures may reach up to 50-85%. Immunosuppressives, principally corticosteroids, are the primary triggering factor. In general, the clinical features of Strongyloides stercoralis hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and starting appropriate therapy. Although recurrent Gram-negative sepsis and meningitis have been previously reported, the combination of both cytomegalovirus (CMV) and strongyloidiasis had rarely been associated...
2016: Case Reports in Transplantation
Chee Wei Tan, Maciej Piotr Chlebicki
A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors...
September 2016: Singapore Medical Journal
Hongwei Ge, Xiaoqing Zheng, Xinzhi Hou, Wenting Ding, Yanqun Na, Yuyong Wang, Zhijian Yu
INTRODUCTION: The traditional procedure for the management of bilateral ureteric stones is staged ureteroscopic lithotripsy(URSL). However, in recent years particularly, some urologists advocate same-session bilateral URSL on the ground of success rates and minimal morbidity. This systematic review is to evaluate the efficacy and safety of same-session bilateral ureteroscopy for the treatment of ureteral calculi. MATERIAL AND METHODS: We conducted a bibliographic search using MEDLINE(1980 to August 2015), EMBASE(1980 to August 2015)...
September 14, 2016: Journal of Endourology
Yuan-Chih Mao, Chin-Lu Chang, Yhu-Chering Huang, Lin-Hui Su, Chao-Tai Lee
BACKGROUND: Providencia stuartii survives well in natural environment and often causes opportunistic infection in residents of long-term care facilities (LTCFs). Clinical isolates of P. stuartii are usually resistant to multiple antibiotics. The bacterium is also naturally resistant to colistin and tigecycline. Treatment of infections caused by carbapenem-resistant P. stuartii is challenging. METHODS: During a 15-month period in 2013-2014, four isolates (P1, P2, and P3B/P3U) of P...
July 29, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Diego Martin Barreiro, Johanna Belén Losada, Francisco Castro Montiel, Norberto Lafos
Case report of a patient who, while being under study due to total urinary incontinence and multiple urinary tract infections, interoccurs with urosepsis due to a forgotten and encrusted double-J stent. An open surgery is performed with two surgical approaches, suprapubic and minimal lumbotomy, in which a nephrectomy of the atrophic kidney, a resection of the urether with a calcified double-J in its interior and a cystolithotomy were conducted with the resulting favorable resolution of the pathology.
September 2016: Urology Case Reports
L-D Qiao, S Chen, X-F Wang, W-M Yang, Y-J Niu, C-Z Kong, W Tang, X-F Gao, B-K Shi, Y-Q Na, X-D Zhang, J-Y Wang, Y Zhang, Z Chen
By comparing the safety and efficacy of 500 mg of oral levofloxacin for 3 days with those of intravenous antibiotics for 3 days in the prevention of infectious complications of ultrasound-guided transrectal prostate biopsy (TPB), we provided a safe and cost-effective infection preventive protocol for TPB in China. A total of 801 patients with indications for TPB in 12 centers were randomized into two groups from October 2011 to December 2015. Patients in the test group (n = 392) took 500 mg of oral levofloxacin for 3 days...
November 2016: European Journal of Clinical Microbiology & Infectious Diseases
Duygu Kayar Calili, Nevzat Mehmet Mutlu, Ayse Pinar Mutlu Titiz, Zeynep Nur Akcaboy, Eda Macit Aydin, Isil Ozkocak Turan
Fahr Syndrome is a rare disease where calcium and other minerals are stored bilaterally and symmetrically in the basal ganglia, cerebellar dentate nucleus and white matter. Fahr Syndrome is associated with various metabolic disorders, mainly parathyroid disorders. The presented case discusses a 64-year old male patient admitted to the intensive care unit of our hospital diagnosed with aspiration pneumonia and urosepsis. The cranial tomography examination to explain his nonspecific neurological symptoms showed bilateral calcifications in the temporal, parietal, frontal, occipital lobes, basal ganglia, cerebellar hemisphere and medulla oblongata posteriorly...
August 2016: JPMA. the Journal of the Pakistan Medical Association
Johanna Haiko, Laura E Savolainen, Risto Hilla, Anu Pätäri-Sampo
Complicated urinary tract infections, such as pyelonephritis, may lead to sepsis. Rapid diagnosis is needed to identify the causative urinary pathogen and to verify the appropriate empirical antimicrobial therapy. We describe here a rapid identification method for urinary pathogens: urine is incubated on chocolate agar for 3h at 35°C with 5% CO2 and subjected to MALDI-TOF MS analysis by VITEK MS. Overall 207 screened clinical urine samples were tested in parallel with conventional urine culture. The method, called U-si-MALDI-TOF (urine short incubation MALDI-TOF), showed correct identification for 86% of Gram-negative urinary tract pathogens (Escherichia coli, Klebsiella pneumoniae, and other Enterobacteriaceae), when present at >10(5)cfu/ml in culture (n=107), compared with conventional culture method...
October 2016: Journal of Microbiological Methods
J Gozdowska, M Czerwińska, Ł Chabros, G Młynarczyk, A Kwiatkowski, A Chmura, M Durlik
INTRODUCTION: The aim of this study was to investigate risk factors for urinary tract infections (UTI), the causative organisms of UTI and also their management and treatment. In addition, we evaluated the effects of UTI on renal graft function. METHODS: This analysis included 107 kidney transplant recipients (64% women) with a diagnosis of UTIs confirmed by positive results on urine culture. Type of pathogens, sensitivity to drugs, risk factors for infection, incidence of urosepsis, hospitalization period, treatment methods, and recurrence rates were analyzed...
June 2016: Transplantation Proceedings
J Gołębiewska, A Dębska-Ślizień, B Bułło-Piontecka, B Rutkowski
BACKGROUND: Renal transplantation is the renal replacement therapy of choice in patients with end-stage lupus nephritis (LN). The aim of this study was to evaluate the early and late outcomes of renal transplantation in LN patients in a single transplant center. PATIENTS AND METHODS: This study analyzed the clinical data of patients who received a renal transplant (RTx) at Gdańsk Transplantation Centre between January 1999 and December 2014. RESULTS: There were 1296 RTx performed between January 1999 and December 2014, including 21 RTx in 19 LN patients (mean age 40 ± 10 years, 89% female)...
June 2016: Transplantation Proceedings
Sultan S AlKhateeb, Nayf A AlShammari, Mohand A AlZughaibi, Yahya G Ghazwani, Khalid A Alrabeeah, Nasser M Albqami
OBJECTIVES: To study the prevalence of urinary tract infections (UTI), or sepsis secondary to trans-rectal ultrasound-guided (TRUS) biopsy of the prostate, the pathogens involved, and patterns of antibiotic resistance in a cohort of patients. METHODS: This is a descriptive study of a consecutive cohort of patients who underwent elective TRUS biopsy at King Abdulaziz Medical City, Riyadh, Saudi Arabia between January 2012 and December 2014. All patients who underwent the TRUS guided prostate biopsy were prescribed the standard prophylactic antibiotics...
August 2016: Saudi Medical Journal
Abdullah Aljorayid, Roberto Viau, Laila Castellino, Robin L P Jump
Serratia fonticola is an unusual human pathogen, previously described primarily as causing skin and soft tissue infections following trauma. There is little information in the literature about its treatment or susceptibilities. We describe the case of a 67-year-old male with paraplegia who developed urosepsis due to S. fonticola. Blood and urine cultures obtained prior to the initiation of antimicrobials both grew S. fonticola. The patient completed a 15-day course of antimicrobials and had an uneventful recovery...
2016: IDCases
Florian M Wagenlehner, Jakhongir F Alidjanov
INTRODUCTION: Urinary tract infections (UTIs) are the second most common nosocomially acquired infections, responsible for approximately 21% of healthcare-associated pyelonephritis and 10.5% of urosepsis. Worldwide trends of increasing resistance resulted in the urgent need for novel antimicrobials that would be active against bacterial resistance mechanisms as an alternative to carbapenems, which are considered last resort antibiotics. AREAS COVERED: The current review is based on a Medline search of published English language literature and contains summary information regarding the evaluation of pharmacologic properties, efficacy, safety and activity of ceftolozane+tazobactam against common bacterial resistance mechanisms...
August 2016: Expert Opinion on Drug Metabolism & Toxicology
D Y Mah, H J Yia, W S Cheong
Dialysis disequilibrium syndrome (DDS) is a neurological disorder with varying severity that is postulated to be associated with cerebral oedema. We described a case of DDS resulting in irreversible brain injury and death following acute haemodialysis. A 13-year-old male with no past medical history and weighing 30kg, presented to hospital with severe urosepsis complicated by acute kidney injury (Creatinine 1422mmol/L; Urea 74.2mmol/L, Potassium 6.3mmol/L, Sodium 137mmol/L) and severe metabolic acidosis (pH 6...
April 2016: Medical Journal of Malaysia
James P Blackmur, Neil U Maitra, Rajendar R Marri, Fadi Housami, Manar Malki, Craig McIlhenny
INTRODUCTION: To investigate which patient, stone, infective, and surgical factors were most likely to increase the risk of postoperative urosepsis within 28 days of ureteroscopy (URS) and laser stone fragmentation for ureteral or renal stones. METHODS: Data were collected prospectively in a single National Health Service institution. A logistic regression model was used to assess the association of factors with postoperative urosepsis. Two matched-pair analyses were used to assess the risk of postoperative urosepsis in patients with (a) an emergency presentation to hospital with urosepsis in the 90 days preceding URS and (b) a positive midstream sample of urine (MSSU) identified, but who were asymptomatic at preoperative assessment, who then received an appropriate course of antibiotics...
September 2016: Journal of Endourology
Tommaso Cai, Luca Gallelli, Andrea Cocci, Daniele Tiscione, Paolo Verze, Michele Lanciotti, Davide Vanacore, Michele Rizzo, Mauro Gacci, Omar Saleh, Gianni Malossini, Giovanni Liguori, Carlo Trombetta, Damiano Rocco, Alessandro Palmieri, Riccardo Bartoletti, Marco Carini, Florian M E Wagenlehner, Kurt Naber, Vincenzo Mirone, Truls E Bjerklund Johansen
OBJECTIVE: To compare fosfomycin trometamol (FT) and ciprofloxacin (CIP) for antibiotic prophylaxis in transrectal prostate biopsy (TR-PB). PATIENTS AND METHODS: Data for 1109 patients (mean age 66.7 ± 8.45) who underwent TR-PB between March to September 2015 in seven Italian urological institutions were retrospectively reviewed, of which 632 received FT (Group 1) and 477 received CIP (Group 2) for prophylaxis. We reviewed all urine culture results obtained after the procedure, all adverse drug reactions (ADRs) related to the drug and all febrile and/or symptomatic urinary tract infections (UTIs) occurring within 1 month after TR-PB...
May 31, 2016: World Journal of Urology
Durre Shohab, Nadeem Iqbal, Muhammad Umar Alam, Amna Butt, Mohammad Imran Jamil, Ijaz Hussain, Saeed Akhter
OBJECTIVE: To compare the outcome of percutaneous nephrolithotomy (PCNL) in terms of operative time, hospital stay, stone clearance, and postoperative complications in adult versus paediatric patients. STUDY DESIGN: Descriptive case series. PLACE AND DURATION OF STUDY: Shifa International Hospital, Islamabad, from January 2010 to December 2013. METHODOLOGY: Aretrospective analysis of 155 patients who underwent PCNL from January 2010 to December 2013...
May 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
C Wim Ang, Antonia H M Bouts, John W A Rossen, Martijn Van der Kuip, Marc Van Heerde, Arend Bökenkamp
We describe an 8-month-old girl with diarrhea, urosepsis and hemolytic uremic syndrome caused by Escherichia coli. Typing of cultured E. coli strains from urine and blood revealed the presence of virulence factors from multiple pathotypes of E. coli. This case exemplifies the genome plasticity of E. coli and the resulting heteropathogenic strains.
September 2016: Pediatric Infectious Disease Journal
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