Dirk Lange, PhD, presents the take home messages on infection/inflammation from the AUA annual meeting in Orlando, FL, including studies pointing to the utility of obtaining rectal swab cultures prior to prostate biopsy to identify patients harboring fluoroquinolone-resistant bacteria and guide antibiotic prophylaxis.
Click here for more Best of AUA 2014 coverage
• Results from multiple studies point to the utility of obtaining rectal swab cultures prior to prostate biopsy to identify patients harboring fluoroquinolone-resistant bacteria and guide antibiotic prophylaxis. One study reported >10% of men were carriers of fluoroquinolone-resistant bacteria and that the post-biopsy sepsis rate decreased from 1.9% to 0.28% after implementation of pre-biopsy cultures, despite an increase in fluoroquinolone resistance.
• Compliance of U.S. urologists with AUA best practice guidelines for perioperative antibiotic prophylaxis in urologic surgery increased between 2007 and 2012, but 41% of urologists were still noncompliant, raising concern that some are adhering to older practice patterns that may provoke resistance.
• Bacteriology is the same in women with first-time and recurrent urinary tract infections, but the antibiotic susceptibility patterns of the two groups are strikingly different, indicating that urinalysis is essential to guide appropriate antibiotic therapy for women with recurrent UTIs.
• A decision and cost analysis for treatment of uncomplicated Escherichia coli cystitis using data from 18 Massachusetts hospitals determined nitrofurantoin (Macrobid, Macrodantin, Furadantin) was the most cost-effective agent for first-line treatment. Due to the potential for region/site-specific differences, such analyses need to be done using local antibiograms.
• A study of patients with neurogenic bladder and catheter-associated UTI found isolation of extended spectrum beta lactamase (ESBL) producing Escherichia coli increased over a 4-year period, particularly in nosocomial infections; the data raise concern about spread of ESBL resistance in hospitals and suggest a need for stringent screening protocols upon patient admission and potential isolation.
• Near-infrared spectroscopy to determine bladder tissue oxygen saturation is a promising method for rapid diagnosis of lower UTI.
• Isothermal calorimetry assessment of UTI isolates generates antibiotic susceptibility profiles within 7 hours, significantly decreasing the time from bacterial isolation to antibiotic therapy.
• An in vivo mouse model for interstitial cystitis/bladder pain syndrome will facilitate investigations of pathologic mechanisms of these disorders and therapeutic development.
• A prospective study with 5 years of follow-up suggests long-term cyclosporine A (Gengraf, Neoral, Sandimmune) is a promising treatment for refractory interstitial cystitis; outcomes showed significant improvements in symptom score, initial filling sensation, bladder capacity, and quality of life.UT
Subscribe to Urology Times to get monthly news from the leading news source for urologists.
Study examines patient knowledge of urinary tract infections
July 11th 2024"The objective of this study was to assess baseline knowledge about urinary tract infections, interest in health resources, and platform preferences for health information acquisition and dissemination," says Stephanie Gleicher, MD.
Destigmatizing Urology: Dr. Winter discusses STDs/STIs
March 22nd 2022“We need to just approach STIs as the medical conditions they are because until we do, and until we take those stigmas away, people will truly have resistance to discussing it, hesitance to discussing it, and resistance to diagnosis and intervention,” says Ashley Winter, MD.
Burden of care for recurrent UTI is higher for female urologists
June 15th 2024"What we believe is happening is women are seeking the help of female urologists, and therefore, because of the nature of the condition, the female urologists are absorbing the burden of the care of these patients, particularly the non-billable burden," says Debra L. Fromer, MD.
Predictive model quantifies risk of antibiotic resistance in uUTI
May 24th 2024The predictive models identified the number of previous UTI episodes, prior β-lactam nonsusceptibility, prior fluoroquinolone treatment, Census Bureau region (particularly in the South), and race as key predictors of having a non-susceptible isolate to 3 or more antibiotic classes.