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1. AKUTE UND CHRONISCHE PROSTATITIS - WAS IST WICHTIG FÜR DIE PRAXIS?

Author

K.G. Naber, W. Vahlensieck, and F.M.E. Wagenlehner

Subjects
akute prostatitis, chronische prostatitis, chronisches schmerzsyndrom im kleinen becken, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Die Prostatitis ist eine häufige und komplexe Erkrankung. Im Verlauf der letzten 40 Jahre haben sich verschiedene Stadien der wissenschaftlichen Wahrnehmung, zum Teil mit Erfolgen und zum Teil mit Irrwegen aufgezeigt. Während die akute Prostatitis fast immer einer akuten bakteriellen Infektion entspricht, finden sich beim chronischen Prostatitissyndrom nur in etwa 10 % der Fälle ursächliche Erreger. Das Erregerspektrum entspricht im Wesentlichen dem von komplizierten Harnwegsinfektionen mit vornehmlich Gram-negativen Erregern. In manchen Studien wurden aber auch atypische Erreger, wie Chlamydia trachomatis und Mykoplasmen gefunden. Bei der überwiegenden Mehrzahl der Fälle werden multifaktorielle Ursachen angenommen. Dies führte schließlich zur Phänotypisierung der Beschwerdesymptomatik mit multimodalen Therapiekonzepten. Bei eindeutig infektiöser (Mit-)Ursache der Beschwerden haben Antibiotika – allen voran Fluorchinolone – nach wie vor einen hohen Stellenwert. Ansonsten erfolgen multimodale Therapiestrategien, die auf Evidenz-basierten monotherapeutischen Studien aufbauen. Bisher liegen nur wenige Studien zu multimodalen Kombinationstherapien vor, die aber durchaus vielversprechend sind.

Published
2016
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2. Report on microbial and resistance patterns of the causative pathogens of nosocomially-acquired urinary tract infections: Preliminary data analysis of the GPIU-Studies 2015-2020

Author

J.F. Alidjanov, C. Ifland, F. Ifland, G. Sass, J. Medina-Polo, A. Magyar, T. Perepanova, F. Bruyère, A. Pilatz, T. Cai, J. Abdusalamov, E. Kulchavenya, Z. Tandogdu, B. Köves, B. Wullt, R. Bartoletti, G. Bonkat, K.G. Naber, F.M.E. Wagenlehner, and T. Bjerklund-Johansen

Subjects
Urology
Published
2022
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5. New drugs for Gram-positive uropathogens

Author

K.G. Naber and F.M.E. Wagenlehner

Subjects
Microbiology (medical), medicine.drug_class, Antibiotics, Microbial Sensitivity Tests, Urine, Microbiology, chemistry.chemical_compound, Daptomycin, Levofloxacin, Acetamides, Drug Resistance, Bacterial, medicine, Humans, Pharmacology (medical), Gram-Positive Bacterial Infections, Oxazolidinones, business.industry, Linezolid, General Medicine, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, Antimicrobial, Gatifloxacin, Anti-Bacterial Agents, Gram-Positive Cocci, Ciprofloxacin, Infectious Diseases, chemistry, Urinary Tract Infections, Vancomycin, business, medicine.drug
Abstract

Complicated urinary tract infections (UTIs) are frequent nosocomial infections. The bacterial spectrum encompasses Gram-negative but also Gram-positive pathogens in up to 30-40%. The existing treatment for Gram-positive pathogens is not always optimal. Antimicrobials for the treatment of Gram-positive uropathogens comprise older agents, such as aminopenicillins with or without beta-lactamase inhibitors and vancomycin, as well as newer fluoroquinolones, such as levofloxacin or gatifloxacin. However, resistant bacteria such as vancomycin-resistant enterococci (VRE) or methicillin-resistant Staphylococcus aureus (MRSA) (except vancomycin-resistant) are generally also not susceptible to the fluoroquinolones. Therefore new agents need to be assessed in the treatment of UTI. Daptomycin and linezolid are new antimicrobial agents with good efficacy against Gram-positive uropathogens as shown by their minimal inhibitory concentrations. In a phase II study the urinary bactericidal activity of linezolid versus ciprofloxacin in volunteers showed comparable activity of both drugs against fluoroquinolone susceptible Gram-positive uropathogens, whereas linezolid was also as active against fluoroquinolone resistant ones. The pharmacokinetics and the mode of action of these two antibiotics are discussed together with some clinical data in the context of therapeutic use in patients with complicated UTIs.

Published
2004
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6. Antibiotics and Resistance of Uropathogens

Author

K.G. Naber and F.M.E. Wagenlehner

Subjects
medicine.medical_specialty, Modern medicine, Antibiotic resistance, Resistance (ecology), business.industry, medicine.drug_class, Urology, Antibiotics, Medicine, business, Intensive care medicine, Antimicrobial
Abstract

This article shall give an overview of the commonly used antibiotics in urological practice, their resistance rates and the resistance mechanisms of uropathogens. The bacterial spectrum of urinary tract infections and the resistance rates of uncomplicated community acquired and complicated, nosocomially acquired uropathogens can differ substantially from region to region and over time. The results from different surveillance studies are evaluated and exemplary the resistance rates of uropathogens in the last ten years of our institution are reflected. Especially the increasing resistance of enterobacteria to fluoroquinolones is notable. Antibiotics are widely used in urological practice for the need of modern medicine and therefore antibiotic resistance is of increasing importance for the urologist. Knowledge of resistance rates is paramount for empirical antimicrobial therapy. A basic understanding of the resistance mechanisms is of great help in this respect.

Published
2004
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7. Clinically significant borderline resistance of sequential clinical isolates of Klebsiella pneumoniae

Author

Frank Notka, Hans-Jörg Linde, Peter Heisig, C. Irtenkauf, Jochen Decker, Norbert Lehn, and F.M.E. Wagenlehner

Subjects
Microbiology (medical), biology, Klebsiella pneumoniae, medicine.drug_class, Antibiotics, Microbial Sensitivity Tests, General Medicine, biochemical phenomena, metabolism, and nutrition, Blotting, Northern, biology.organism_classification, Enterobacteriaceae, Microbiology, Ciprofloxacin, Infectious Diseases, Drug Resistance, Bacterial, medicine, Pulsed-field gel electrophoresis, Humans, Pharmacology (medical), Ofloxacin, Efflux, Antibacterial agent, medicine.drug
Abstract

Two sequential clinical isolates of Klebsiella pneumoniae (Kpn) were isolated from bronchoalveolar lavage fluid (Kpn#1) and sputum (Kpn#2) of a patient with pneumonia, complicated by anatomical and immunosuppressive problems due to Wegener's granulomatosis. Despite 4 weeks of systemic treatment with ciprofloxacin (CIP) Kpn#2 was isolated thereafter. A fluoroquinolone-resistant mutant (Kpn#1-SEL) was derived from Kpn#1 in vitro by selecting on agar plates supplemented with ofloxacin. Kpn#1, Kpn#1-SEL and Kpn#2 had an identical pattern in PFGE. CIP MICs were 0.25, 2 and 4 mg/l for Kpn#1, Kpn#2 and Kpn#1-SEL, respectively. Kpn ATCC 10031 (CIP MIC 0.002 mg/l) served as control. We analyzed mechanisms of fluoroquinolone resistance by determining antibiotic susceptibility, organic solvent tolerance, accumulation of fluoroquinolones, dominance testing with wild-type topoisomerase genes (gyrA/B, parC/E), sequencing of the quinolone resistance determining regions of gyrA/B, parC/E and marR and Northern blotting of marR and acrAB genes. Compared with Kpn ATCC 10031, elevated MICs to fluoroquinolones and unrelated antibiotics in Kpn#1 was presumably due to a primary efflux pump other than AcrAB and increased the CIP MIC 125-fold. Although Kpn#1 tested sensitive according to NCCLS breakpoints, the elevated CIP MIC of 0.25 mg/l presumably rendered this isolate clinically resistant and lead to therapeutic failure in this case. Further increase of MIC to fluoroquinolones in vivo and in vitro was distinct. Kpn#1-SEL, selected in vitro, acquired a GyrA target mutation, whereas in Kpn#2 no known resistance mechanism could be detected.

Published
2003
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9. Risiken und Komplikationen in der Urologie

Author

J. Kühn, C. K. Lackner, K. Burghofer, S. Schmidt, W. Beyer, A. Hillmer, S. Blaut, C. Frohme, C. Reichardt, G. Janetschek, C. Lassahn, K. Eisenblätter, Joachim Steffens, T. Otto, R. Hofmann, J. Fichtner, S. Richter, S. C. Müller, T. Kälble, W. Weidner, J. H. Witt, K. W. Köhrmann, R. Thiel, T. Enzmann, A. Hegele, H. Sperling, N. Rolfes, J. Noldus, J. Neu, N. Fischer, A. Dietel, A. Stenzl, U. Grein, C. Wagner, A. Kocot, C. Hampel, C. Eimer, C. Doehn, Petra Anheuser, J. W. Thüroff, A. Lampel, H.-H. Seifert, A. Mottrie, M. Günther, M. Streibelt, R. v. Knobloch, S. Neudorf, S. Abulsorour, O. Luzar, S. Classen, P. J. Bastian, J.-U. Stolzenburg, D. Kröpfl, N. Kreutzer, A. S. Brandt, C.-H. Sparwasser, M. Musch, G. Schön, C. Ziesel, B. J. Schmitz-Dräger, H.-J. Knopf, S. Kliesch, R. Bartmuß, S. Riechardt, I. Rübben, H. Heynemann, S. Rausch, M. Stöckle, H. Leyh, J. Steffens, G. Breuer, M. Lehsnau, J. Grosse, J. Bedke, G. Lümmen, B. Reisch, M. Daufratshofer, M. F. Hamann, M. Gans, H. Schulte-Baukloh, F. Greco, M. Härtlein, P. Anheuser, A. Pilatz, R. Häußermann, A. Gunnemann, C. Wülfing, S. Vogel, F.M.E. Wagenlehner, M. Beuke, B. Altinkilic, C. Göser, L. Lusuardi, V. Zugor, P. Firek, T. Maurer, D. Thüer, K.-P. Jünemann, T. Allkemper, T. Diemer, M. Spahn, G. Hofmockel, S. Roth, T. Pottek, F. Steinbach, B. Kopper, T. Knoll, J. Gschwend, M. Sommerauer, J. Oswald, E. Bismarck, U. Rebmann, E. Herrmann, P. Schneede, S. Siemer, D. Colleselli, R. Rabenalt, D. Wiessner, L. Meyer, A.-K. Ebert, P. Fornara, B. Liedl, W. Merkle, H. Riedmiller, M. Staehler, M. Fisch, U. Janssens, W. Werner, A. Heidenreich, G. Niegisch, M. Hruza, P. Albers, A. Labanaris, M. C. Truß, D. Pfalzgraf, B. Volkmer, A. Soave, R. Dahlem, F. Gottardo, U. Schütz, W. H. Rösch, A. Treiyer, M. Graefen, H. M. Do, A. Kaminsky, J. J. Rassweiler, and G. Fechner

Published
2012
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10. Autorenverzeichnis

Author

W. Domschke, M. Berger, W. Hohenberger, T. Meinertz, C. Vogelmeier, T. Sauerbruch, H.J. Kramer, S.C. Müller, H. Serve, M.M. Weber, B. Göke, J.R. Kalden, B. Manger, W. Rascher, B. Appenrodt, J. Atta, C. Auernhammer, I.B. Autenrieth, W. Avenhaus, M. Backmund, C. Bausewein, J. Behr, A. Behrens, R. Berner, F. Berr, N. Blank, E. Blind, M. Bockhorn, D. Bokemeyer, M. Böhm, G. Bönner, G.D. Borasio, K. Bork, J. Braun, H.-P. Bruch, T.H. Brümmendorf, U. Brunnberg, M. Brüwer, M.W. Büchler, C. Detter, S. Diederich, C. Diehm, J. Distler, D. Domagk, T. Dörner, H.-G. Dörr, H. Dralle, M. Dreyling, I. Ehlebracht-König, C. Ell, W. Enzensberger, H.-J. Epple, M. Fassnacht, H. Feußner, P. Fiegel, C. Fisang, D. Filipas, W. Fischbach, C.H. Flamme, J. Floege, U.R. Fölsch, C. Fottner, W. Frank, N. Frey, K. Friese, A. Frilling, M. Fröhner, P. Frühmorgen, P.R. Galle, S. Geidel, E. Genth, A. Gingelmaier, F.-D. Goebel, N. Gökbuget, R. Göke, K. Grabitz, M. Grünke, S. Hahner, W. Handrick, C. Hasslacher, E. Heidbreder, W. Heindel, V. Heinemann, J. Heitmann, H.W. Heiß, H. Hof, L. Hering, E. Hiller, A. Hirner, W.-K. Hofmann, E. Holler, A.H. Hölscher, G. Holtmann, J. Hölzen, J. Honegger, S. Hörle, K. Hörmann, R. Hörmann, I. Hornke, R.M. Huber, J. Hübner, R. Hummel, S. Irmscher, T. Jelinek, S. Jonas, E. Jost, H.H. Jung, G.J. Kahaly, M. Karaus, S. Katsoulis, H. Katus, H.P. Kessler, K. Kiehne, W. Kiess, M. Kindermann, Y. von Kodolitsch, H. Köhler, L. Köhler, M. Köhler, E. Kohne, H.-J. Kolb, J. Köninger, K. Koop, R. Köster, I. Kötter, H.J.J. Kramer, B. Kremer, P. Kroll, J.G. Kuipers, F. Lammert, M. Langer, M. Laukötter, H. Lehnert, B. Lembcke, M.M. Lerch, S. Liebe, A. Lieber, R. Loddenkemper, M. Löhr, H.-M. Lorenz, J. Lorenz, T. Löscher, M. Luster, G. Lux, K. Mann, J. Mayerle, U. Merle, H.-J. Meyer, C. Möbius, M. Moehler, H. Mönnikes, J. Mössner, S.A. Müller, T.J. Musholt, J. Nattermann, M. Neubrand, P. Neuhaus, B. Neundörfer, T. Nicolai, J. Nolde, H. Olschewski, J. Ostermeyer, C. Ott, S. Pahernik, U. Pankratius, K.G. Parhofer, B. Passlick, O. Pech, B. Pfaffenbach, T. Pfeiffer, A. Pilatz, T. Pohle, A. Pohl-Koppe, Katharina A. Ponto, H. Prange, A. Pruß, J. Rädle, B. Rauch, F. Raue, C. Reichel, C. Reindl, C. Reißfelder, Dipl.-Phys. J. Rendl, E. Rietschel, E. Rijcken, R. Roos, G. Rudofsky†, W. Samtleben, W. Sandmann, G. Sauter, K.P. Schaal, J.R. Schaefer, U. Schäfer-Graf, W. Schepp, M. Schlemmer, S. Schliep, H. Schmidt, B. Schmied, W. Schmiegel, A. Schießl, A. Schmid, A. Schneider, T. Schneider, J. Schölmerich, H. Scholz, U. Schönermarck, J. Schopohl, H. Schrezenmeier, H. Schulze-Koops, D. Schuppan, V. Schuster, G. Schüßler, O. Schwandner, T.F. Schwarz, R. Secknus, N. Senninger, O. Sezer, B.R. Simmen, U. Spengler, U. Stabenow-Lohbauer, R. Stebler, D. Steven, M. Sticherling, U. Strauch, C. Stremmel, W. Stremmel, B.A. Stuck, H. Stürz, C. Taube, O. Thulesius, K. Thurau, J.W. Thüroff, C. Tomiak, W. Uhl, D. Vallböhmer, T. Vogel, P. von den Driesch, F.M.E. Wagenlehner, A. Wagner, U. Wagner, K. Weber, W. Weidner, T. Weinke, B.T. Weis-Müller, M. Weiß, S. Willems, U. Wintergerst, M. Wirth, G.W. Wolkersdörfer, and M. Zeitz

Published
2011
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11. Spectrum and antibiotic resistance of uropathogens from hospitalised patients with urinary tract infections: 1994-2005

Author

F.M.E. Wagenlehner, A.H. Niemetz, W. Weidner, and K.G. Naber

Subjects
Microbiology (medical), Inpatients, Infectious Diseases, Bacteria, Drug Resistance, Bacterial, Urinary Tract Infections, Humans, Pharmacology (medical), General Medicine, Bacterial Infections, Microbial Sensitivity Tests, Anti-Bacterial Agents
Abstract

From 1994-2005, all uropathogens cultured from the urine of hospitalised urological patients were identified and their sensitivity was tested against the most important antibiotics for the treatment of urinary tract infection (UTI). Duplicate isolates were eliminated. The following results were obtained: (i) there was no general trend of increase in resistance; (ii) certain uropathogens developed resistance to some antibiotics; (iii) vancomycin- or linezolid-resistant staphylococci or enterococci did not play a role; (iv) the lowest overall rates of resistance were found with piperacillin/tazobactam; and (v) ciprofloxacin and trimethoprim/sulfamethoxazole showed the next favourable overall activity. Adequate initial antibiotic therapy is critical in the treatment of severe UTI. Therefore, ongoing surveillance of antibiotic resistance must be performed in every institution. Additionally, it reflects antibiotic and hospital infection policies in a defined department or institution.

Published
2007

12. Prostatitis

Author

A. Pilatz, F.M.E. Wagenlehner, and W. Weidner

Subjects
medicine.medical_specialty, business.industry, Urology, medicine, Prostatitis, medicine.disease, business
Published
2007
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15. 37 Infective complications after prostate biopsy: Outcome of the Global Prevalence of Infections in Urology (GPIU) prostate biopsy side study 2010 – a multinational, multicenter study

Author

F.M.E. Wagenlehner, Oostrum E. Van, P. Tenke, Z. Tandogdu, M. Cek, M. Grabe, K.G. Naber, W. Weidner, T.E. Bjerklund-Johansen, and null GPIU study group

Subjects
medicine.medical_specialty, Prostate biopsy, medicine.diagnostic_test, Multicenter study, business.industry, Urology, medicine, business
Published
2012
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16. CXA-101

Author

G. Perletti, V. Magri, F.M.E. Wagenlehner, and K.G. Naber

Subjects
Pharmacology, Pharmacology (medical)
Published
2010
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