Neisseria gonorrhoeae is one of the important pathogens of sexually transmitted infections. N. gonorrhoeae is rapidly becoming antimicrobial resistant, and there are few drugs that are effective in ...the initial treatment of gonorrhea. To understand the trends of antimicrobial susceptibility of N. gonorrhoeae, the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology conducted the third nationwide antimicrobial susceptibility surveillance of N. gonorrhoeae isolated from male urethritis. The specimens were collected from male patients with urethritis at 30 facilities from May 2016 to July 2017. From the 159 specimens collected, 87 N. gonorrhoeae strains were isolated, and 85 were tested for susceptibility to 21 antimicrobial agents. All strains were non-susceptible to penicillin G. Seven strains (8.2%) were β-lactamase-producing strains. The rates of susceptibility to cefixime and cefpodoxime were 96.5% and 52.9%, respectively. Three strains were non-susceptible with a minimum inhibitory concentration (MIC) of 0.5 mg/L for cefixime. None of the strains were resistant to ceftriaxone or spectinomycin. The susceptibility rate for ciprofloxacin was 23.5% (20 strains), and no strains showed intermediate susceptibility. The susceptibility rate against azithromycin was 81.2%, with one strain isolated with a MIC of 8 mg/L against azithromycin. The results of this surveillance indicate that ceftriaxone and spectinomycin, which are currently recommended for gonococcal infections in Japan, appear to be effective. It will be necessary to further expand the scale of the next surveillance to understand the current status of drug-resistant N. gonorrhoeae in Japan.
The Japanese Surveillance Committee conducted a second nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for acute uncomplicated cystitis (AUC) in ...premenopausal patients aged 16–40 years old at 31 hospitals throughout Japan from March 2015 to February 2016. In this study, the susceptibility of causative bacteria (Escherichia coli, Klebsiella pneumoniae, Staphylococcus saprophyticus) for various antimicrobial agents was investigated by isolation and culturing of organisms obtained from urine samples. In total, 324 strains were isolated from 361 patients, including E. coli (n = 220, 67.9%), S. saprophyticus (n = 36, 11.1%), and K. pneumoniae (n = 7, 2.2%). The minimum inhibitory concentrations (MICs) of 20 antibacterial agents for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. At least 93% of the E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, whereas 100% of the S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 6.4% (13/220) and 4.1% (9/220), respectively. The antimicrobial susceptibility of K. pneumoniae was retained during the surveillance period, while no multidrug-resistant strains were identified.
In summary, antimicrobial susceptibility results of our second nationwide surveillance did not differ significantly from those of the first surveillance. Especially the numbers of fluoroquinolone-resistant and ESBL-producing E. coli strains were not increased in premenopausal patients with AUC in Japan.
Abstract The Japanese surveillance committee conducted the first nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for female acute uncomplicated cystitis ...at 43 hospitals throughout Japan from April 2009 to November 2010. In this study, the causative bacteria ( Escherichia coli and Staphylococcus saprophyticus ) and their susceptibility to various antimicrobial agents were investigated by isolation and culturing of bacteria from urine samples. In total, 387 strains were isolated from 461 patients, including E. coli ( n = 301, 77.8 %), S. saprophyticus ( n = 20, 5.2 %), Klebsiella pneumoniae ( n = 13, 3.4 %), and Enterococcus faecalis ( n = 11, 2.8 %). S. saprophyticus was significantly more common in premenopausal women ( P = 0.00095). The minimum inhibitory concentrations of 19 antibacterial agents used for these strains were determined according to the Clinical and Laboratory Standards Institute manual. At least 87 % of E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, and 100 % of S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant E. coli strains and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 13.3 % and 4.7 %, respectively. It is important to confirm the susceptibility of causative bacteria for optimal antimicrobial therapy, and empiric antimicrobial agents should be selected by considering patient characteristics and other factors. However, the number of isolates of fluoroquinolone-resistant or ESBL-producing strains in gram-negative bacilli may be increasing in patients with urinary tract infections (UTIs) in Japan. Therefore, these data present important information for the proper treatment of UTIs and will serve as a useful reference for future surveillance studies.
Two hundred and thirty-eight children (170 males, and 68 females) with nocturnal enuresis were retrospectively studied for lower urinary tract problems. Surgical correction of subclinical organic ...obstruction in the lower urinary tract was evaluated for the improvement of bed-wetting.
One hundred and fifty-five micturating cystourethrography (MCU), and 89 urodynamic studies were performed. Optic internal urethrotomy was done in a boy, and meatoplasty in a girl for urethral 'ring' stenosis (URS).
Nocturnal enuresis was found in 153 cases and nocturnal enuresis associated with daytime enuresis in 67 cases. Vesicoureteral reflux was found in 30, URS in 42, and posterior urethral valve in 3 cases on MCU. Detrusor instability was recognized in 39.4% of 38 cases of nocturnal enuresis associated with daytime enuresis and in 25.0% of 51 cases of nocturnal enuresis. Surgery brought 73.8% improvement of bed-wetting in 42 cases.
Surgical correction of subclinical obstruction in the lower urinary tract might contribute to the earlier resolution of bed-wetting in children with nocturnal and/or diurnal enuresis.
Biapenem (BIPM), a new carbapenem antibiotics, was administered to 21 patients with complicated urinary tract infections at a daily dose of 0.3 or 0.6 or 0.9g for 5 days. Clinical efficacy as ...evaluated by the criteria of the Japanese UTI Committee was excellent in 4, moderate in 11, poor in 1 patients, an efficacy rate of 94%. Bacteriological response showed elimination of 25 of 26 strains isolated from patients. No adverse reactions were observed clinically, but in laboratory findings elevations of liver enzymes were noted in 2 cases.
Vesicouterine fistula: a case report Tanaka, K; Chokyu, H; Yoshimura, K ...
Hinyokika kiyo. Acta urologica Japonica
42, Številka:
8
Journal Article
A 25-year-old woman suffered a vesicouterine fistula following cesarean section. Cystoscopic fulguration of the fistula was attempted, resulting in disappearance of incontinence. Two months later, ...incontinence recurred and open surgical repair was performed transabdominally. After resection and closure of the fistula with the help of peritoneal flap interposition, the patient became free from incontinence.
We report a case of tuberculous spondylitis after intravesical bacillus Calmette-Guerin (BCG) instillation. A 71-year-old man was administered BCG (80mg per week) for 8weeks for prophylactic ...treatment of bladder cancer. After the first instillation he experienced miction pain, pollakisuria, and febrile episodes. Two months after the completion of BCG instillation, he complained to back pain and spinal X-ray showed a lytic lesion of Th7 vertebra. Diagnosis of metastatic transitional cell carcinoma was made based on MRI and bone scan. But pathological findings at laminectomy revealed tuberculous spondylitis. Antituberculous therapy (SM, RFP, and INH) was instituted and anterior supine fusion was performed. Now he is free from bladder cancer and tuberculous infection. Intravesical BCG instillation is effective for superficial bladder cancer, but it should be kept in mind that complications related to this treatment could occur and the adequete antituberculos treatment has to be insisted if indicated.
The prostatic tissue levels of Levofloxacin (LVFX, DR-3355) were determined in 20 patients undergoing the TUR surgery. The concentrations of LVFX in the prostatic tissue were measured by ...high-perfomance liquid chromatography a after single oral dose of LVFX 100mg. The maximum concentration of LVFX in the prostatic tissue was 1.79±1.34μg/g 2 hours after administration and the prostatic tissue/serum ratio (P/S) was 1.86±0.88. These data show that penetration of LVFX into the prostate was good. Based on these results, clinical effectivness of LVFX can be expected for bacterialprostatitis.
A case of renal cell carcinoma with extremely high serum carcinoembryonic antigen (CEA) levels is presented. A 57-year-old female complained of left flank pain. Computerized tomographic (CT) scan ...revealed left renal tumor and laboratory examination revealed an extremely high serum level of CEA (815 ng/ml). No abnormal findings were recognized in gastrointestinal or genital systems. Radical nephrectomy was done. The histology was renal cell carcinoma (RCC, intermediate type, mixed type, pleomorphic cell type, G3 > G2, INF gamma, pT2, pV0). Tumor cells were positive for CEA by ABC-peroxidase staining. Levels of tumor markers decreased after operation. However, CEA levels rose again and lymph node metastases appeared. She died 6 months after operation.
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