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신보성,김선욱,황인상,황의창,오경진 대한배뇨장애요실금학회 2012 International Neurourology Journal Vol.16 No.1
We report a case of genital swelling in a patient receiving continuous ambulatory peritoneal dialysis. A physical examination did not identify any defect. Ultrasonography revealed a large hydrocele, and surgical repair brought resolution of the genital swelling. Two months later, however, the genital swelling had recurred and was not improved until peritoneal dialysis was replaced by hemodialysis 3 months later.
경직장초음파 유도하 전립선 생검 후 ciprofloxacin 내성균에 의한 세균혈증의 임상 특성
신보성,정승일,황의창,권동득,박광성,류수방,김진웅 대한요로생식기감염학회 2011 Urogenital Tract Infection Vol.6 No.1
Purpose: Fluoroquinolone is considered the prophylactic antibiotic of choice for Transrectal ultrasound (TRUS)-guided biopsy. However, failure of quinolone prophylaxis due to emerging quinolone-resistant enterobacteriae has been increasing. We reviewed bacteremia cases after TRUS-guided biopsy to identify antibiotic-resistant bacterial strains with the objective to prevent urosepsis. Materials and Methods: A total of 2,348 patients underwent TRUS-guided biopsy at our institution between January 2004 and December 2009. All patients received intravenous ciprofloxacin for prophylaxis. We retrospectively evaluated patients who developed infectious symptoms, such as fevers and chills. Results: Eleven (0.4%) of 2,348 patients developed infectious symptoms. Escherichia coli was the pathogen responsible for post-biopsy infections occurring in a; 11 (100%) patients with positive blood cultures, which confirmed ciprofloxacin-resistant E. coli, with one isolate producing extended-spectrum beta lactamase. Ten out of 11 E. coli isolates (91%) were resistant to ampicillin and 9 of 11 E. coli isolates (82%) were resistant to gentamicin. Ten out of 11 E. coli isolates (91%) were susceptible to third generation cephalosporins. All such patients were admitted to the hospital and treated with a third generation cephalosporin. One patient who habored an E. coli isolate producing extended-spectrum beta-lactamase received imipenem. Conclusions: Ciprofloxacin is effective in reducing infectious complications. However, recently, bacteremiccases are increasing due to ciprofloxacin resistant E. coli. For patients with infectious symptoms after transrectal prostate biopsy, early antibiotics change, including third generation cephalosporins, are recommended to prevent urosepsis.
Antibiotic Prophylaxis in Radical Prostatectomy: Comparison of 2-Day and More than 2-Day Prophylaxis
신보성,정호석,황의창,정승일,권동득 대한의학회 2017 Journal of Korean medical science Vol.32 No.6
The efficacy of antibiotic prophylaxis in radical prostatectomy (RP) remains to be established. We retrospectively compared the occurrence of perioperative infections after RP between the 2 different antibiotic protocols. This study involved 428 cases of laparoscopic radical prostatectomy (LRP). After excluding patients who had no perioperative urine culture data, 313 consecutive patients who underwent LRP for prostate carcinoma were classified into 2 groups according to the duration of antimicrobial prophylaxis. To group 1 (153 patients), a second-generation cephalosporin was administered for less than 2 days, whilst the remaining 160 patients in group 2 were administered the drug for more than 2 days. The overall incidence of postoperative bacteriuria was 50.8%, being significantly higher in group 1 (56.9%) than in group 2 (45%). The incidence of surgical site infection (SSI) was significantly higher in group 1 (5.2%) than in group 2 (0.6%). Multivariate analysis revealed that old age, duration of antibiotics for more than 2 days, and duration of Foley catheter placement were independently associated with postoperative infectious complications (all, P < 0.05). Multivariate analysis revealed that duration of antibiotics for more than 2 days, duration of Foley catheter placement, and duration of surgical drain placement were independently associated with postoperative SSI (all, P < 0.05). The incidence of postoperative bacteriuria and SSI were higher in patients who received antibiotics for a short duration. Based on our results, we demonstrated that the outcome of postoperative infectious complications is dependent on old age, short antibiotic administration duration, and prolonged Foley catheterization. Prolonged drain placement is associated with SSI, whilst a longer duration of antibiotics use and prolonged Foley catheterization are associated with a decrease in the incidence of SSI.