Search

Abstract  The purpose of this study was to clarify the clinical relevance of carbapenem and third-generation cephalosporin treatment for febrile complicated pyelonephritis, which often leads to urosepsis. Parenteral antimicrobial treatment with a carbapenem or third-generation cephalosporin was administered to febrile patients and the treatment was switched to oral antimicrobial agents after they became afebrile. In principle, the duration of the course of antimicrobial chemotherapy was limited to a total of 14 days. Clinically, the success rates were 97.3% in the carbapenem group and 96.0% in the third-generation cephalosporin group. For microbiological efficacy, the success rates were 89.2% in the carbapenem group and 92.0% in the third-generation cephalosporin group. There were no serious adverse events in the course of the study. The treatment regimen with a carbapenem or a third-generation cephalosporin was highly effective for patients with febrile complicated pyelonephritis and was well tolerated. Either of these regimens could become one of the standard treatments for patients with febrile complicated pyelonephritis. [ABSTRACT FROM AUTHOR]

Abstract  Urinary tuberculosis has been rare in recent years and its diagnosis is difficult because there are no disease-specific symptoms. We tried to clarify the occurrence of urinary tuberculosis in recent years in our area. During the past 5 years, there were 12 patients with urinary tuberculosis in the clinics that participated in this study. Their chief complaints were frequent voiding in 7 patients and gross hematuria in 3 patients. They were diagnosed by nucleic acid amplification tests and imaging modalities such as excretory urography, computed tomography, and/or cystoscopy. Most of the patients received multidrug treatment and had relatively favorable treatment outcomes. There has been a small but neglected number of patients with urinary tuberculosis in recent years. We should keep this rare and difficult-to-diagnose disease in mind and suspect it when patients complain of longstanding urinary symptoms with no obvious cause. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the incidence rates of asymptomatic sexually transmitted infections (STI) in young men in Sapporo, Japan. A survey of 204 healthy male volunteers was conducted. First-voided urine specimens were used for detection of Chlamydia trachomatis and Neisseria gonorrhoeae with polymerase chain reaction assay, and cotton swab wiping of the external genitalia was used for detection of human papillomavirus (HPV) with the Hybrid Capture method. The incidence rates were 3.4% for C. trachomatis and 5.9% for HPV. No N. gonorrhoeae was detected. In sexually active men who had regular sexual intercourse, the detection rate of C. trachomatis was 4.7% and that of HPV was 8.0%. Our study showed that the incidence rates of asymptomatic STIs were not negligible, and that we should provide screening programs for young men with a high risk for such unrecognized infections and study their natural histories. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish a standard protocol for surgical antimicrobial agents for patients who received transurethral ureterolithotripsy (TUL). We retrospectively reviewed the medical charts of patients who received TUL. From October 2002 to December 2003, 2 days (total, four times) of antimicrobial prophylaxis (AMP) was done, and from January 2004 to December 2004, single prophylaxis was done. We analyzed the incidence of postoperative fever and other factors associated with TUL and compared these factors between the 2-day-AMP and single-AMP groups. Of 135 patients with TUL, 66 patients were in the single-AMP group and 69 in the 2-day-AMP group. The incidences of postoperative fever were 4.5% in the single-AMP group and 11.6% in the 2-day-AMP group. No statistically significant difference was found in the incidence of postoperative fever between the two groups. Our study showed that single AMP was effective for patients receiving a TUL operation. In the future, a prospective randomized study will be needed for a large series, with various types of lithotripters being included. [ABSTRACT FROM AUTHOR]

The nucleic acid amplification test (NAAT) has been valuable in the diagnosis of urinary tuberculosis; however, no studies have attempted to determine the significance of NAAT post treatment. We encountered three patients with urinary tuberculosis who underwent sequential NAAT during antituberculosis chemotherapy and post treatment. All patients were diagnosed as having urinary tuberculosis by positive NAAT and specific renal deformity revealed by imaging. In two of the three patients, positive culture results were obtained and one was negative in standard culture. During antituberculosis chemotherapy, a negative NAAT was obtained from 3 to 5 months after the start of treatment and no positive culture results were obtained during the same period. At the end of chemotherapy, 6 months or more after the start of medication, all patients had negative NAAT results. These results suggest that NAAT for Mycobacterium tuberculosis provides an effective and rapid detection method for urinary tuberculosis both pre- and post-treatment. [ABSTRACT FROM AUTHOR]