INCIDENCE OF URINARY TRACT INFECTION AFTER CYSTOGRAPHY

ABSTRACT Objective: Cystography an invasive procedure with potential complications such as urinary infection (UI). There are few studies about the incidence of complications associated with this procedure. The purpose of this study is to evaluate the incidence of post-cystography urinary infection (UI.). Methods: Retrospective study with a review of clinical records of patients under 15 years of age, followed in this hospital, who underwent cystography (radiologic or indirect radionuclide) between 2009 and 2018. Post-cystography UI was defined when it occurred until seven days after the procedure. Descriptive and nonparametric statistics were applied to assess possible predictive factors related with post-cystography UI. Results: In the study period, 531 cystograms were undertaken (55% indirect radionuclide and 45% radiologic). The mean age at the procedure was 11.5 months; 62% were boys. Every patient had a previous negative urine culture; 50% were under antibiotic prophylaxis at the time of the procedure. The most common indication for the procedure was the post-natal study of congenital hydronephrosis/other nephrological malformation (53%), followed by the study of febrile UI (31%). Vesicoureteral reflux (VUR) was diagnosed in 40% of procedures. Post-cystography UI occurred in 23 cases (incidence of 4.3%). The most frequent microorganism was E. coli (52%). The presence of VUR was significantly associated with the occurrence of post-cystography IU. Conclusions: The incidence of post-cystography UI was low in our sample. The presence of VUR was significantly associated with the occurrence of post-cystography UI. The authors highlight the importance of an adequate catheterization technique and the need for clinical surveillance after the procedure.

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Incidental Prostate Infections: Developing the Prostate Microbiome

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.301 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S138-S138

Author(s):

D Daniel ◽

A Zuretti

Keyword(s):

Prostate Cancer ◽

Urine Culture ◽

Rectal Biopsy ◽

Inclusion Criteria ◽

Klebsiella Species ◽

New Techniques ◽

E Coli ◽

Prostate Biopsies ◽

Negative Urine Culture ◽

Common Infections

Abstract Introduction/Objective About 1 in 9 men will be diagnosed with prostate cancer in their lifetime. The traditional method of diagnosis is via a 12 core, trans-rectal biopsy. While this has been an appropriate method of investigation, a rectal approach to the prostate core made it difficult to differentiate prostatic bacterial infection from fecal contamination. Utilizing a sterile trans-perineal approach for biopsy, we were able to establish a true microbiome of the prostate, without contamination. Methods This is a prospective, IRB approved study. Men who were required to have prostate biopsies were offered a trans-perineal or trans rectal method of biopsy. Those who opted for trans-perineal biopsy with a negative urine culture met the inclusion criteria. Urine culture was performed prior to scheduling for the procedure. At time of biopsy, sterile cultures were taken from the rectum and one randomly selected prostate core. Cultures were grown for 5 days, and the results were recorded. Results Of the 93 patients who met inclusion criteria, eight men contained various bacteria within the sterilely accessed prostate core. Of the eight prostate cores which grew positive cultures, five of those patients had an isolated prostatic infection, without rectal or urinary co-infection. The most common infections included E. coli (n=2) and Klebsiella species (n=3). Conclusion New techniques in the performance of prostate biopsy provides the microbiology laboratory unique opportunities for investigation. This is the beginning of the study of the prostate microbiome, and future correlation with prostate cancer and isolated prostate infection are areas of future inquiry.

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EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.1.16 ◽

2017 ◽

pp. 103-106

Author(s):

Minh Duc Pham

Keyword(s):

Laparoscopic Appendectomy ◽

Single Port ◽

Operation Time ◽

Invasive Procedure ◽

Minimal Invasive ◽

University Hospital ◽

Early Results ◽

Sils Port ◽

The Mean ◽

A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

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URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.3.16 ◽

2018 ◽

pp. 100-108

Author(s):

Dinh Khanh Le ◽

Dinh Dam Le ◽

Khoa Hung Nguyen ◽

Xuan My Nguyen ◽

Minh Nhat Vo ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Clinical Manifestations ◽

University Hospital ◽

E Coli ◽

Positive Urine ◽

Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

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Does age at aortic coarctation repair have an impact on left ventricle size and function?

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.108 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

S Cardoso Torres ◽

CX Resende ◽

PG Diogo ◽

P Araujo ◽

RA Pinto ◽

...

Keyword(s):

Aortic Coarctation ◽

Surgical Repair ◽

Myocardial Dysfunction ◽

Global Longitudinal Strain ◽

Negative Relationship ◽

Late Complications ◽

Left Ventricular ◽

Funding Sources ◽

The Mean ◽

Clinical Records

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Adults with repaired aortic coarctation (CoA) require lifelong follow-up due to late complications, including left ventricular (LV) myocardial dysfunction. Age at the time of CoA repair is an important prognostic factor in these patients (pts). Purpose To evaluate LV size, ejection fraction (EF) and global longitudinal strain (GLS) values using 2D speckle tracking echocardiography (STE) in a population of adult pts with repaired CoA and to assess the relationship between these echocardiographic parameters and age at the time of CoA repair. Methods Retrospective analysis of adult pts with repaired CoA, followed in a Grown Up Congenital Heart Disease Centre. Pts with hemodynamically significant concomitant cardiac lesions were ruled out. Epidemiologic and clinical data were obtained from clinical records. Transthoracic echocardiograms were reviewed in order to assess GLS using 2DSTE (Echopac Software, GE). Results The study population consisted of 63 pts (61.9% male), with a mean age of 35.3 years at the time of the echocardiographic evaluation. The mean age at the time of the CoA repair was 117 months (95% CI 89.8-144.1 months). Surgical repair was performed in 46 pts (73%): resection with subclavian artery flap aortoplasty (n = 21); patch aortoplasty (n = 15) and head-to-head anastomosis (n = 10). In 10 pts there was no data regarding the type of surgical repair. Seven pts (11.1%) were submitted to percutaneous intervention (6 with aortic stent implantation and 1 with balloon aortic angioplasty). Mean LVEF was 63.4% (CI 95% 55.6 – 71.2%) and mean LV end-diastolic diameter (LVEDD) was 50mm (CI 95% 43-57mm). Mean GLS was - 17.3 (CI 95% 14.8- 19.8), which is inferior to the mean normal values reported for the software used. Age at the time of CoA repair had a statistically significant positive linear relationship with LVEDD (r= 0.282; p= 0.026) and a linear negative relationship with both GLS (r= -0,29; p= 0.022) and LVEF (r= -0.33; p= 0.05). Conclusion Older age at the time of CoA repair was associated with increased LVEDD and decreased GLS and LVEF. Also, GLS may be an important tool for the identification of subclinical LV dysfunction in adult pts with repaired CoA.

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THE DNA OF CAENORHABDITIS ELEGANS

Genetics ◽

10.1093/genetics/77.1.95 ◽

1974 ◽

Vol 77 (1) ◽

pp. 95-104

Author(s):

J E Sulston ◽

S Brenner

Keyword(s):

Caenorhabditis Elegans ◽

Chemical Analysis ◽

Dna Sequences ◽

Base Composition ◽

Nematode Caenorhabditis Elegans ◽

5S Rna ◽

Base Pairs ◽

Small Component ◽

E Coli ◽

The Mean

ABSTRACT Chemical analysis and a study of renaturation kinetics show that the nematode, Caenorhabditis elegans, has a haploid DNA content of 8 x IO7 base pairs (20 times the genome of E. coli). Eighty-three percent of the DNA sequences are unique. The mean base composition is 36% GC; a small component, containing the rRNA cistrons, has a base composition of 51% GC. The haploid genome contains about 300 genes for 4s RNA, 110 for 5s RNA, and 55 for (18 + 28)S RNA.

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Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.626 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s118-s120

Author(s):

Austin R. Penna ◽

Taniece R. Eure Eure ◽

Nimalie D. Stone ◽

Grant Barney ◽

Devra Barter ◽

...

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Antibiotic Susceptibility ◽

Clinical Decision Making ◽

Service Providers ◽

Urine Culture ◽

Nursing Home Residents ◽

Antibiotic Prescribing ◽

E Coli ◽

Susceptibility Data

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.Disclosures: NoneFunding: None

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Urinary Excretion and Bactericidal Activities of a Single Oral Dose of 400 Milligrams of Fleroxacin versus a Single Oral Dose of 800 Milligrams of Pefloxacin in Healthy Volunteers

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.42.7.1659 ◽

1998 ◽

Vol 42 (7) ◽

pp. 1659-1665 ◽

Cited By ~ 15

Author(s):

Kurt G. Naber ◽

Ursula Theuretzbacher ◽

Martina Kinzig ◽

Orlin Savov ◽

Fritz Sörgel

Keyword(s):

Oral Dose ◽

Healthy Volunteers ◽

Single Oral Dose ◽

E Coli ◽

Wide Range ◽

The Mean ◽

Bactericidal Activities ◽

Tract Infections ◽

Time Kill ◽

Randomized Crossover Study

ABSTRACT Twelve healthy volunteers participated in this randomized crossover study to compare the concentrations and recovery levels of fleroxacin and pefloxacin in urine and to assess their bactericidal activities against 12 strains of urinary pathogens with different susceptibilities over a wide range of MICs. The volunteers received a single oral dose of 400 mg of fleroxacin or 800 mg of pefloxacin. The mean cumulative renal excretion of unchanged fleroxacin,N-demethyl-fleroxacin, and N-oxide-fleroxacin accounted for 67, 7, and 6% of the total dose, respectively. The total urinary recovery of pefloxacin and the active metabolite norfloxacin was 34%. In the time-kill and the urinary bactericidal titer (UBT) studies, only the subjects’ urine not supplemented with broth was used. With most tested organisms and both quinolones it took more than 8 h to achieve a reduction in CFU of 99.9% (3 log units). Overall, there was a good correlation between UBTs and MICs for the strains. Against Escherichia coli ATCC 25922 the median UBTs were similar for both antibiotics and at least 1:8 for 96 h; against the E. coli strain for which the MIC was 0.5 μg/ml the UBT was at least 1:4 for 48 h. The UBTs of both drugs against Klebsiella pneumoniae were at least 1:16 for 72 h. The UBTs for Staphylococcus aureus (the MIC for which was 16 μg/ml) of both antibiotics were low, and in some of the samples, no bactericidal titers were observed. UBTs for Proteus mirabilis of pefloxacin are significantly higher than those of fleroxacin. For Pseudomonas aeruginosa the median UBTs were present for the 24-to-48-h interval. The same is true forEnterococcus faecalis. Against Staphylococcus saprophyticus, UBTs were present for at least 48 h with both quinolones. Overall, a single oral dose of 400 mg of fleroxacin exhibits UBTs comparable to those of 800 mg of pefloxacin. Therefore, it may be expected that half of the dose of fleroxacin gives comparable results in the treatment of urinary tract infections; this should be substantiated in comparative clinical trials.

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Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v6i1.27070 ◽

2019 ◽

Vol 6 (1) ◽

pp. 8-13

Author(s):

Birendra Kumar Yadav ◽

Robin Bahadur Basnet ◽

Anil Shrestha ◽

Parish Mani Shrestha

Keyword(s):

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Urine Culture ◽

Operation Time ◽

Group A ◽

One Year ◽

Group B ◽

Stone Characteristics ◽

Negative Urine Culture ◽

Infective Complications

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture.

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Prescribing practices in psychiatric hospitals in Eastern Europe

European Psychiatry ◽

10.1016/j.eurpsy.2010.05.005 ◽

2011 ◽

Vol 26 (7) ◽

pp. 414-418 ◽

Cited By ~ 11

Author(s):

V. Jordanova ◽

N.P. Maric ◽

V. Alikaj ◽

M. Bajs ◽

T. Cavic ◽

...

Keyword(s):

Eastern Europe ◽

Western Europe ◽

Atypical Antipsychotics ◽

Psychiatric Care ◽

Anticholinergic Drug ◽

Psychiatric Hospitals ◽

Evidence Based ◽

Prescribing Practices ◽

The Mean ◽

Clinical Records

AbstractBackgroundThere has been no evidence about the prescribing practices in psychiatric care in Eastern Europe.AimsTo examine the patterns of psychotropic prescribing in five countries of Eastern Europe.MethodWe conducted a one-day census of psychiatric treatments used in eight psychiatric hospitals in Albania, Croatia, Macedonia, Serbia and Romania. We examined clinical records and medication charts of 1304 patients.ResultsThe use of polypharmacy was frequent across all diagnostic groups. Only 6.8% of patients were on monotherapy. The mean number of prescribed drugs was 2.8 (SD 0.97) with 26.5% receiving two drugs, 42.1% receiving three drugs and 22.1% being prescribed four or more psychotropic drugs. Typical antipsychotics were prescribed to 63% and atypical antipsychotics to 40% of patients with psychosis. Older generations of antidepressants were prescribed to 29% of patients with depression. Anxiolitic drugs were prescribed to 20.4% and benzodiazepines to 68.5% of patients. One third of patients received an anticholinergic drug on a regular basis.ConclusionsOlder generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.

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Bifurcated bypass in severe chronic limb threatening ischaemia

Vascular ◽

10.1177/1708538121999856 ◽

2021 ◽

pp. 170853812199985

Author(s):

Daniele Adami ◽

Michele Marconi ◽

Alberto Piaggesi ◽

Davide M Mocellin ◽

Raffaella N Berchiolli ◽

...

Keyword(s):

Survival Rates ◽

Primary Patency ◽

Free Survival ◽

Mortality And Morbidity ◽

Bypass Patency ◽

Stage 4 ◽

Endovascular Approach ◽

The Mean ◽

Clinical Records

Objectives Revascularization according to the angiosome concept is of proven importance for limb salvage in chronic limb threatening ischaemia but it is not always practicable. Bifurcated bypasses could be considered as an option when an endovascular approach is not feasible or has already failed and a single bypass would not allow direct revascularization of the ischaemic area. Bifurcated bypasses are characterized by landing on two different arteries, the main artery (in direct continuity with the foot vessels) and the secondary one (perfusing the angiosome district). The aim of this study is to evaluate the safety and effectiveness of bifurcated bypass in chronic limb threatening ischaemia. Methods Thirty-five patients were consecutively treated with a bifurcated bypass for chronic limb threatening ischaemia from January 2014 to December 2019 in a single vascular surgery centre. Data from clinical records and operative registers were collected prospectively in an electronic database and retrospectively analysed. Primary and primary assisted bypass patency, amputation-free survival, morbidity and mortality rates at 12 and 24 months were analysed. Results Mean follow-up period was 25.1 months (range 2–72 months). Thirty-six bifurcated bypasses were performed on 35 patients (age 75.3 ± 7.2 years; 69.4% were male). According to Wound, Ischemia, foot Infection classification 22.2% belonged to stage 3 and 77.8% to stage 4 and the mean Rutherford’s class was 5.1 ± 0.7. Immediate technical success was 100%. Early mortality and morbidity rates were respectively 5.5%, and 33.3%; foot surgery was performed in 50% of cases with wound healing in all patients. Primary patency and primary assisted bypass patency were 96.7% and 100% at 6 months; 85.2% and 92% at 12 months, 59.9% and 73.4% at 24 months, respectively. Amputation-free survival at 12 and 24 months was, respectively, 95.6% and 78.8%. Overall survival rates at 12 and 24 months were respectively 94.4% and 91.6%. Conclusions Bifurcates bypass can provide good results in patients with chronic limb threatening ischaemia without endovascular option, especially in diabetic ones. Bifurcated bypass is a complex surgical solution, both to be planned and performed, and it is quite invasive for frail patients that should be accurately selected.

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