RESUMEN
We describe a gonorrhoea case with ceftriaxone plus high-level azithromycin resistance. In April 2022, an Austrian heterosexual male was diagnosed with gonorrhoea after sexual intercourse with a female sex worker in Cambodia. Recommended treatment with ceftriaxone (1 g) plus azithromycin (1.5 g) possibly failed. Worryingly, this is the second strain in an Asian Neisseria gonorrhoeae genomic sublineage including high-level azithromycin-resistant strains that developed ceftriaxone resistance by acquisition of mosaic penA-60.001. Enhanced resistance surveillance and actions are imperative to prevent spread.
Asunto(s)
Gonorrea , Trabajadores Sexuales , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Austria , Azitromicina/farmacología , Azitromicina/uso terapéutico , Ceftriaxona/farmacología , Ceftriaxona/uso terapéutico , Farmacorresistencia Bacteriana/genética , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/epidemiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Neisseria gonorrhoeae/genética , Insuficiencia del TratamientoRESUMEN
PURPOSE: To detect possible effects of magnetic resonance imaging (MRI) scans on the function of an InterStim Twin sacral nerve stimulation (SNS) device and on patient's health. There is no authorization for MRI scans in InterStim Twin SNS at all. MATERIAL AND METHODS: 10 patients with Interstim Twin sacral nerve stimulator implants underwent a singular MRI scan. Before the MRI was performed, the SNS device function was evaluated and the device was deactivated be the implanting urologist. A continuous monitoring took place during MRI procedure. Micturition-time chart pre- and post MRI procedures were conducted. After the MRI session was completed, the implanted device was examined once more and reactivated, function then was evaluated. RESULTS: A total of 10 patients required MRI examinations in 8 different body regions. No patient reported pain or discomfort during and after the MRI scan. After reactivation of the InterStim Twin device following the MRI, impedances and stimulation amplitude, micturition frequency, urgency, and incontinence episodes remained stable. No significant differences between pre- and post MRI were found (p>0.05). CONCLUSION: This is the first report of patients successfully undergoing a MRI scan despite a previously implanted Interstim Twin sacral nerve stimulator. No negative effect of SNS function or negative side effects for the patients were observed.
Asunto(s)
Terapia por Estimulación Eléctrica , Síntomas del Sistema Urinario Inferior/terapia , Plexo Lumbosacro , Imagen por Resonancia Magnética , Trastornos Urinarios/terapia , Anciano , Anciano de 80 o más Años , Electrodos Implantados , Femenino , Humanos , Plexo Lumbosacro/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Seguridad del Paciente , Estudios RetrospectivosRESUMEN
AIM: The aim of this study was to assess possible impacts of multiple magnetic resonance imaging (MRI) scans on the function of InterStim™ sacral neurostimulator systems (SNS; Medtronic Inc.) devices and on patient's safety. METHODS: Over the course of 17 years, a total of 16 patients required 72 MRI examinations in various parts of the body. Each time an MRI was performed, the implanting urologist evaluated the SNS device function and deactivated the implant before the scan. Patients were monitored continuously during and after the procedure. After the MRI session, the site of the implanted device was examined, and the SNS device was reactivated. RESULTS: None of the patients experienced pain or discomfort during or after the MRI scan. Impedances and stimulation amplitudes were recorded before and after MRI and showed no statistically significant changes regarding implant function. Micturition-time charts after MRI procedures were compared with previous records and showed no deviations either. No negative consequences of multiple MRIs have been observed. CONCLUSION: This is the first report of patients successfully undergoing multiple MRI scans despite a previously implanted SNS. Sixteen patients underwent more than one MRI scan, with no negative effect on the functional outcome of SNS or negative side effects for the patients.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Electrodos Implantados/efectos adversos , Imagen por Resonancia Magnética/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , SacroRESUMEN
OBJECTIVE: To compare prostate volume and prostate-specific antigen (PSA) levels with bacterial growth in prostate tissue cultures. MATERIALS AND METHODS: Fifty male patients who underwent transurethral prostate resection were investigated prospectively. Resection chips from the prostate gland were added to brain-heart infusion medium and incubated. PSA levels were determined preoperatively at our urology ward. The prostate gland volume was estimated by transabdominal ultrasound examination preoperatively. RESULTS: Persons with positive bacterial prostate tissue cultures have a greater prostate volume. This is significant in patients with and without histopathologic signs of prostatitis. Persons with positive bacterial prostate tissue cultures have higher PSA values. This is significant in patients without histopathologic signs of prostatitis. CONCLUSION: People with positive bacterial prostatic tissue culture have a higher prostate volume in comparison with patients with negative culture findings and show a tendency toward increased PSA levels as well.
Asunto(s)
Antígeno Prostático Específico/sangre , Próstata/microbiología , Próstata/patología , Hiperplasia Prostática/patología , Neoplasias de la Próstata/patología , Prostatitis/patología , Anciano , Anciano de 80 o más Años , Bacterias/crecimiento & desarrollo , Recuento de Colonia Microbiana , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Estudios Prospectivos , Próstata/cirugía , Hiperplasia Prostática/sangre , Hiperplasia Prostática/microbiología , Hiperplasia Prostática/cirugía , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/microbiología , Neoplasias de la Próstata/cirugía , Prostatitis/sangre , Prostatitis/complicaciones , Prostatitis/microbiología , Técnicas de Cultivo de Tejidos , Resección Transuretral de la PróstataRESUMEN
INTRODUCTION: The objective of this study was to identify the types of bacterial colonization of the prostate gland tissue and urine pre- and postoperatively in patients undergoing a transurethral resection (TUR) of the prostate gland. In addition, clinical symptoms and histopathological findings were included. MATERIAL AND METHODS: Forty three patients were investigated. Urine test strips and urine cultures were taken pre- and postoperatively and intraoperatively prostate resection chips were taken for culture. RESULTS: A positive bacterial culture was found in 20 of 43 (46.5%) patients. Preoperatively, a positive bacterial culture was found in 12 patients and postoperatively in 7 patients. Thirteen patients showed a positive culture of the prostate gland tissue. No patient showed the same bacterial isolates in all 3 samples. Postinterventionally, 6 patients of the group with positive bacterial cultures developed complications. From the group of patients without bacterial growth, only one patient developed a postoperative complication. CONCLUSION: The bacterial colonization in the 3 different cultures showed an inhomogeneous spectrum of bacteria without a reproducible pattern. Nevertheless, it clearly demonstrates that the group with a positive culture is at great risk to develop postoperative complications.