ObjectiveTo evaluate the effectiveness and safety of low-concentration hydrogen peroxide solution (HPS) for continuous bladder irrigation after transurethral resection of the prostate (TURP).

METHODSWe retrospectively analyzed the clinical data about 148 cases of benign prostatic hyperplasia (BPH) treated by TURP from January 2013 to January 2016. Seventy-six of the patients received postoperative continuous bladder irrigation with 0.15% HPS (group A) and the other 72 with normal saline (group B). We compared the two groups of patients in their postoperative hemoglobin (Hb) levels, duration of bladder irrigation, frequency of catheter blockage, time of catheterization, and length of hospital stay.

RESULTSThere were no statistically significant differences between the two groups of patients preoperatively in the prostate volume, International Prostate Symptoms Score, maximum urinary flow rate, postvoid residual urine, or levels of serum PSA and Hb (P > 0.05). At 48 hours after operation, a significantly less reduction was observed in the Hb level in group A than in group B (［3.38 ± 2.56］ vs ［7.29 ± 6.58］ g/L, P < 0.01). The patients of group A, in comparison with those of group B, also showed remarkably shorter duration of postoperative bladder irrigation (［32.57 ± 5.99］ vs ［46.10 ± 8.79］ h, P < 0.01), lower rate of catheter blockage (3.3% vs 11.8%, P < 0.01), shorter time of catheterization (［3.74 ± 0.79］ vs ［4.79 ± 0.93］ d, P < 0.01), and fewer days of postoperative hospital stay (［4.22 ± 0.81］ vs ［4.67 ± 0.88］ d, P < 0.01).

CONCLUSIONSLow-concentration HPS for continuous bladder irrigation after TURP can reduce blood loss, catheter blockage, bladder irrigation duration, catheterization time, and hospital stay, and therefore deserves a wide clinical application.

Anti-Infective Agents, Local ; administration & dosage ; Catheter Obstruction ; Humans ; Hydrogen Peroxide ; administration & dosage ; Length of Stay ; Male ; Postoperative Hemorrhage ; prevention & control ; Postoperative Period ; Prostatic Hyperplasia ; blood ; surgery ; Quality of Life ; Retrospective Studies ; Therapeutic Irrigation ; methods ; statistics & numerical data ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; prevention & control ; Urinary Retention

Escherichia coli (E. coli) is a clinically important causative organism that can lead to urinary tract infections. Quinolone antibiotics are among the first-line treatments for urinary tract infections. However, the frequency of resistance to quinolone in E. coli has been increasing. Therefore, new antimicrobial agents that can be used for treatment in lieu of quinolone antibiotics are needed. In this study, thirty-six compounds with higher scores in a virtual screening based on the three-dimensional structure of E. coli DNA gyrase were selected for in vitro antimicrobial activity testing. An in vitro test confirmed the antimicrobial activity of 4-[(1-methyl-6-nitroquinolin-1-ium-4-yl)amino]-N-[4-[(1-methylpyridin-1-ium-4-yl)amino]phenyl]benzamide (ZINC18057104) against E. coli among the 36 compounds. The minimum inhibitory concentration (MIC) of ZINC18057104 against E. coli ATCC® 25922™ was 2 μg/ml, and the MIC₅₀ and MIC₉₀ for the 72 quinolone-resistant E. coli clinical isolates were 4 and 64 μg/ml, respectively. ZINC18057104, which has a quinoline structure which is similar to the quinolone antibiotics, is predicted to exhibit antimicrobial activity in quinolone-resistant E. coli because it has different molecular interactions with the DNA gyrase than that of existing quinolone antibiotics.
Anti-Bacterial Agents ; Anti-Infective Agents ; DNA Gyrase* ; DNA* ; Drug Discovery ; Escherichia coli ; In Vitro Techniques ; Mass Screening ; Microbial Sensitivity Tests ; Urinary Tract Infections

OBJECTIVE: To examine the ability of an antimicrobial agent Ciprofloxacin to diffuse through a Foley catheter retention balloon.
METHODS: The Utraviolet-Visible (UV-Vis) Spectophotometer (UV-1700 PharmaSpec) was utilized to detect the diffusion of the analyte (Ciprofloxacin) through end parameters such as peak absorbance and corresponding wavelengths.
RESULTS: On UV-Vis spectophotometer, the control sample of sterile water was analyzed and found to have the lowest peak absorbance value of only 0.003 at a wavelength of 343 nm. The peak absorbance values of subsequent samples, taken from the same environment (sterile water), since submersion of the catheter balloon, on day-3, day-8, day-15 had increasing peak absorbance values on their corresponding wavelengths.
CONCLUSIONS: In this study, the samples of sterile water from the outside environment of the submerged catheter yielded progressively increasing peak absorbance values on the succeeding days of submersion. Thereby, In lieu of this principle, one can infr the diffusion of the analyte throgh the catheter membrane, as reflected by the summary of peak absorbance value.

Ciprofloxacin ; Water ; Immersion ; Anti-infective Agents ; Diffusion ; Membranes ; Urinary Catheters

PURPOSE: Burkholderia cepacia is an aerobic, glucose-non-fermenting, gramnegative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. METHODS: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. RESULTS: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28. 6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. CONCLUSION: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.
Amikacin ; Aminoglycosides ; Anti-Infective Agents ; Bacillus ; Burkholderia cepacia* ; Burkholderia* ; Catheters ; Causality ; Ceftazidime ; Child* ; Colistin ; Heart Defects, Congenital ; Humans ; Incidence ; Intensive Care Units ; Medical Records ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Seoul ; Tertiary Care Centers ; Urinary Bladder ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Therapy with appropriate antimicrobial agents is an important component in the management of patients with liver, biliary and pancreatic infection. Acute cholangitis and cholecystitis are common conditions that may result in progressively severe infection. Infectious complications, both pancreatic (infected necrosis) and extrapancreatic (pneumonia, cholangitis, bacteremia, urinary tract infections, and so on), are a major cause of morbidity and mortality in patients with acute pancreatitis. Antimicrobial agents appropriate for initial therapy (empirical therapy or presumptive therapy) for various grades of severity of infections should be used. Local antimicrobial susceptibility patterns should be considered for use.
Anti-Bacterial Agents* ; Anti-Infective Agents ; Bacteremia ; Cholangitis ; Cholecystitis ; Cholecystitis, Acute ; Humans ; Liver ; Mortality ; Pancreatitis ; Urinary Tract Infections

Ampicillin ; therapeutic use ; Anti-Infective Agents ; therapeutic use ; Enterobacteriaceae ; drug effects ; pathogenicity ; Enterobacteriaceae Infections ; drug therapy ; microbiology ; Female ; Hospitals, Military ; Humans ; Male ; Sulbactam ; therapeutic use ; Urinary Tract Infections ; drug therapy ; microbiology

The quinolone class of antimicrobial agents is one of most widely used classes of antimicrobial agents in outpatient and inpatient treatment. However, quinolone resistance in gram-positive and gram-negative bacteria has emerged and increased globally. This resistance limits the usefulness of quinolones in clinical practice. The review summarizes mechanisms of quinolone resistance and its epidemiology and implications in the most common clinical settings, urinary tract infections, respiratory tract infections, intraabdominal infections, skin and skin structure infections, and sexually transmitted diseases.
Anti-Infective Agents ; Drug Resistance ; Epidemiology* ; Gram-Negative Bacteria ; Humans ; Inpatients ; Intraabdominal Infections ; Outpatients ; Quinolones ; Respiratory Tract Infections ; Sexually Transmitted Diseases ; Skin ; Urinary Tract Infections

OBJECTIVE: To investigate the bacterial distribution and resistance to antibiotics in culture-positive urine, and to provide reference for rational use of antibiotics in clinical practice. METHODS: Distribution and antibiotic resistance to pathogens in 658 culture-positive patients from Jan. 1, 2007 to Dec. 31, 2008 were analyzed. RESULTS: (1)Pathogenic strains from the 658 patients were collected from the urine specimen in the survey, which included Gram-negative bacilli (70.82%), Gram-positive cocci (26.14%) and fungi (3.04%). The distribution rate of Escherichia coli declined from 68.91% in 2008 to 63.43% in 2007 (P>0.05), and Enterococcus rose from 3.37% to 7.67% (P>0.05), but the difference was not significant. The proportion of Gram-negative bacilli (especially the E.coli) from patients in the Emergency Department and Out-patient Department was higher than that from in-patients, and the proportion of K. pneumonia and Gram-positive bacteria was lower than in-patients, both with significant differences (P<0.05). (2) The resistance rate of E. coli and K. pneumonia to quinolones was 28.57%-56.25%, and the resistance rate to 3rd generation cephalosporin was 38.78%-65.78%, respectively. The resistance rate of Gram-positive cocci to quinolones and 3rd generation cephalosporin was both higher than 50%, and was 11.05% to Vancomycin. CONCLUSION Gram-negative bacilli such as E. coli and K. pneumonia are predominant organism in the urinary tract infections, but proportion of Gram-positive bacteria has increased in recent years. Attention needs to be paid to the overall and severe bacterial resistance in the urinary tract infections and rational use of antibiotics.
Adult ; Anti-Infective Agents, Urinary ; pharmacology ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; Gram-Negative Bacteria ; isolation & purification ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Male ; Retrospective Studies ; Urinary Tract Infections ; drug therapy ; microbiology ; Urine ; microbiology

Urinary tract infections are common clinical problems in children, even though lots of treatment strategies have been tried. Many studies of the application of probiotics for urinary tract infection in female adults exist, but there is a lack of studies in children. The aims of this study were to screen probiotic strains for inhibiting the uropathogens in vitro, to find candidates for in vivo study. Nine strains of E. coli were isolated from children with urinary tract infection and six uropathogens were obtained from Korean Colletion for Type Cultures and American Type Culture Collection. Also 135 lactic acid bacteria (LAB) strains were isolated from healthy children, and were identified through physiologic, biochemical methods, 16S rDNA PCR, and data analysis. And with agar disk diffusion assay technique the antimicrobial activities of these LAB strains against those uropathogens were examined. Three strains of separated LAB strains demonstrated major antimicrobial activity against all the uropathogens. In the agar disk diffusion assay technique, antimicrobial activities increased most in the 4th day culture broth with separated Lactobacillus. In summary, some LAB can be used as candidates to develop the probiotic microorganisms that inhibit uropathogens in children, and are expected to be applied to treatment and prevention of pediatric urinary tract infection.
Agar/chemistry ; Anti-Infective Agents/pharmacology ; Child ; Culture Media/metabolism ; Diffusion ; Escherichia coli/*metabolism ; Feces ; Humans ; Korea ; Lactic Acid/*metabolism ; Microbial Sensitivity Tests ; Polymerase Chain Reaction ; Probiotics/*metabolism ; RNA, Ribosomal, 16S/metabolism ; Urinary Tract Infections/*microbiology/therapy

PURPOSE: Pseudomonas aeruginosa is an important pathogen in complicated urinary tract infections(UTIs). The aim of this study was to evaluate the isolation rate of Pseudomonas from patients with UTIs and to define the accompanying clinical features. MATERIALS AND METHODS: Between January 2000 and December 2006, we retrospectively reviewed the medical records of 170 urology patients with Pseudomonas UTIs. We analyzed the isolation rate of Pseudomonas in patients with UTIs and determined the antibiotic susceptibilities. We also analyzed the clinical features and underlying diseases in patients with Pseudomonas UTIs. RESULTS: Pseudomonas was cultured in the urine from 234 of 3,470 patients (6.6%) with positive urine cultures. One hundred seventy of 234 patients had underlying urologic disease. Eighty-two patients(48.2%) had indwelling urinary catheters and 34 patients(20.0%) had diabetes. Patients with catheters tended to have febrile UTIs compared to patients without catheters(70.7% vs. 42.0%, respectively). The isolation rate of Pseudomonas increased between 2000 and 2006(2.8% vs. 13.1%, respectively). The sensitivity of Pseudomonas to most antibiotics decreased between 2000 and 2006. Patients with neurogenic disease and catheters were more easily infected with Pseudomonas. CONCLUSIONS: The isolation rate of Pseudomonas in urine cultures is on the rise. Patients with UTIs and catheters, unlike those without, have high fevers. Because the sensitivity of Pseudomonas to antimicrobial agents has decreased, we need to choose appropriate antibiotics through urine cultures and antibiotics sensitivity tests in treating complicated UTIs.
Anti-Bacterial Agents ; Anti-Infective Agents ; Catheters ; Fever ; Humans ; Medical Records ; Pseudomonas ; Pseudomonas aeruginosa ; Retrospective Studies ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Urologic Diseases ; Urology