ObjectiveTo evaluate the effect of cefoxitin prophylactic in reducing the incidence of severe infection after transrectal prostate biopsy (TRPB).

METHODSThis retrospective study included 155 cases of TRPB with a 5-day administration of oral levofloxacin at 200 mg bid (the control group) and another 167 cases with a 3-day administration of oral levofloxacin at the same dose plus intravenous cefoxitin at 2.0 g 2 hours before TRPB (the experimental group) according to the distribution characteristics of drug-resistance bacteria in our department. The patients of the control and experimental groups were aged (68.68 ± 8.12) and (68.72 ± 7.51) years, with PSA levels of (19.78 ± 21.57) and (21.15 ± 42.63) μg/L, involving (11.68 ± 1.44) and (11.77±1.02) biopsy cores, respectively. Comparisons were made between the two groups of patients in the incidence rate of severe infection, which was defined as lower urinary track symptoms plus the systemic inflammatory response syndrome (SIRS) within 7 days after TRPB.

RESULTSThe incidence rate of postoperative severe infection was significantly lower in the experimental group than in the control (0.6% ［1/167］ vs 5.8% ［9/155］, P < 0.05). Blood cultures revealed positive E-coli strains in 6 cases in the control group, including 5 ESBL-positive and 4 quinolone-resistant and amikacin-sensitive cases, all sensitive to cefoxitin, cefoperazone/sulbactam and imipenem. The only one case of severe infection was shown to be negative in blood culture.

CONCLUSIONSPreoperative intravenous administration of cefoxitin according to the specific distribution characteristics of drug-resistance bacteria can significantly reduce the incidence of severe infection after TRPB.

Aged ; Anti-Bacterial Agents ; therapeutic use ; Biopsy ; adverse effects ; methods ; Cefoxitin ; therapeutic use ; Drug Resistance, Bacterial ; Escherichia coli ; isolation & purification ; Escherichia coli Infections ; microbiology ; prevention & control ; Humans ; Levofloxacin ; therapeutic use ; Male ; Middle Aged ; Postoperative Complications ; blood ; prevention & control ; Prostate ; pathology ; Retrospective Studies

Candidiasis ; diagnosis ; Cervical Vertebrae ; surgery ; Esophageal Diseases ; diagnosis ; microbiology ; Esophagus ; microbiology ; Humans ; Postoperative Complications ; microbiology ; Spinal Fusion ; adverse effects

Arthroscopy ; adverse effects ; instrumentation ; methods ; Diagnostic Equipment ; adverse effects ; microbiology ; Disinfection ; methods ; Equipment Failure ; Humans ; Materials Testing ; methods ; Orthopedic Equipment ; adverse effects ; microbiology ; Postoperative Complications ; etiology ; prevention & control

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.
Aged ; Anti-Bacterial Agents/therapeutic use ; Cystectomy/adverse effects ; Enterococcus/isolation & purification ; Escherichia coli/isolation & purification ; Female ; Humans ; Ileum/*surgery ; Incidence ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Reconstructive Surgical Procedures ; Retrospective Studies ; Risk Factors ; Urinary Bladder Neoplasms/*surgery ; Urinary Tract Infections/drug therapy/*epidemiology/etiology/microbiology ; Urodynamics

OBJECTIVETo explore the clinical characteristics, therapeutic measures and risk factors of pulmonary fungal infection in patients after renal transplantation.

METHODSThe clinical data of 176 patients receiving renal allograft transplantation with postoperative infections were retrospectively analyzed. Among the patients, 40 were diagnosed to have pulmonary fungal infection, and their clinical symptoms, signs, radiographic findings, pathogenic bacterial culture, histopathological examination, and treatments were analyzed.

RESULTSThe 40 recipients with postoperative pulmonary fungal infection included 25 male and 15 female patients with a mean age of 49 years. Twenty-eight of the patients developed pulmonary fungal infection within 6 months after transplantation. Positive pathogen cultivation was reported in 19 cases, and Candida albicans was detected in 11 cases, Candida krusei in 2 cases, Candida glabrata in 3 cases, Candida tropicalis in 1 case, aspergillosis in 1 case, and Candida mycoderma in 1 case. Twenty-four of out of the 40 cases were found to have co-infection. All the patients received antifungal drugs and adjuvant treatments, and 38 patients were cured and 2 died.

CONCLUSIONPulmonary fungal infection often occurs within 6 months after renal transplantation. The most common fungal pathogen is Candida albicans, and the patients often had coinfections. Early diagnosis and timely intervention with antifungal drugs and comprehensive measures are critical in the management of pulmonary fungal infection following renal transplantation.

Antifungal Agents ; therapeutic use ; Aspergillus ; isolation & purification ; Candida ; isolation & purification ; Female ; Humans ; Kidney Transplantation ; Lung Diseases, Fungal ; epidemiology ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; microbiology ; Retrospective Studies ; Risk Factors

Actinomycosis ; complications ; Humans ; Laryngeal Neoplasms ; surgery ; Papilloma ; surgery ; Postoperative Complications ; microbiology

No abstract available.
Aged ; Aneurysm/surgery ; Anti-Bacterial Agents/pharmacology ; Brain Diseases/surgery ; Craniotomy/adverse effects ; DNA, Bacterial/chemistry/genetics/metabolism ; Female ; Flavobacteriaceae Infections/etiology/microbiology ; Flavobacterium/classification/drug effects/*isolation & purification ; Humans ; Meningitis/*diagnosis/microbiology ; Microbial Sensitivity Tests ; Phylogeny ; Postoperative Complications ; Sequence Analysis, DNA

Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma following pterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who do not respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologous perichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performed on four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at Gyeongsang National University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified in cultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctival flap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcome was stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchal cartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatment is ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.
Anti-Bacterial Agents/therapeutic use ; Autografts ; Cartilage/surgery ; Communicable Diseases ; Debridement ; Eye Infections, Bacterial/etiology/*therapy ; Female ; Humans ; Ophthalmologic Surgical Procedures ; Postoperative Complications ; Pseudomonas Infections/microbiology/*therapy ; Pseudomonas aeruginosa/*isolation & purification ; Pterygium/surgery ; Republic of Korea ; Sclera/*surgery/transplantation ; Scleritis/microbiology/*therapy ; Surgical Wound Infection/microbiology/*therapy ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo investigate the method and effect of percutaneous nephroscopic necrosectomy (PNN) for post-operatively resident infection of severe acute pancreatitis (SAP).

METHODSData of the 15 SAP patients with post-operatively resident infection treated by PNN from June 2008 to December 2014 in Chinese People's Liberation Army General Hospital were reviewed. Twelve of the patients underwent the laparotomy within 1 week, 1 in 3(rd) week, 1 in 4(th) week and the other one on the 127(th) day. All of the referrals firstly received (multi-)percutaneous catheter drainage (PCD), and then PNN operation according to the disease, followed by continuous irrigation-drainage.

RESULTSEleven patients were healed after received only one PNN operation, 2 patients for twice, 1 for three times and 1 for four times. The average post-operative time of hospital stay was 66.2 days (10-223 days). The complications after operation contained colon fistula (n = 1), abdominal hemorrhage (n = 1), pancreatic pseudocyst (n = 1), severe pulmonary infection (n = 1). Three patients eventually died.

CONCLUSIONSPercutaneous nephroscopic necrosectomy is a minimally invasive approach which could prevent the complicated re-laparotomy operation, result in less complication. It is an ideal method for treating SAP patients with post-operatively resident infection.

Drainage ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Minimally Invasive Surgical Procedures ; Operative Time ; Pancreatitis, Acute Necrotizing ; complications ; surgery ; Postoperative Complications ; microbiology ; Reoperation

This multicenter study was undertaken to determine the efficacy of antibiotic prophylaxis and identify the risk factors for infectious complications after prostate surgery in Korean patients. A total of 424 patients who underwent surgery of the prostate were reviewed. All patients underwent urinalysis and urine culture preoperatively and postoperatively. Efficacy of antibiotic prophylaxis and risk factors for infectious complications were investigated. Infectious complications were observed in 34.9% of all patients. Factors independently associated with infectious complications were diabetes mellitus (adjusted OR, 1.99; 95% CI, 1.09-3.65, P=0.025) and operation time (adjusted OR, 1.08; 95% CI, 1.03-1.13, P=0.004). Clinicians should be aware of the high risk of infectious complications in patients with diabetes and those who undergo a prolonged operation time. Neither the type nor duration of prophylactic antibiotics resulted in differences in infectious complications.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Antibiotic Prophylaxis ; Diabetes Mellitus, Type 2/complications ; Drug Resistance, Bacterial/drug effects ; Enterococcus/drug effects/isolation & purification ; Escherichia coli/isolation & purification ; Humans ; Klebsiella pneumoniae/drug effects/isolation & purification ; Male ; Middle Aged ; Odds Ratio ; Postoperative Complications/microbiology/prevention & control ; Prospective Studies ; Prostatic Neoplasms/complications/*surgery ; Quinolones/pharmacology ; Risk Factors ; Time Factors ; Transurethral Resection of Prostate ; Urinalysis ; Urinary Tract Infections/microbiology