Molecular characteristics of carbapenem-resistant Pseudomonas aeruginosa isolated from urine in Hyogo, Japan.

OBJECTIVES: To investigate the molecular characteristics and epidemiology of metallo-ß-lactamase-producing Pseudomonas aeruginosa from urine of urinary tract infection patients in Hyogo Prefecture, Japan. METHODS: Carbapenem-resistant P. aeruginosa isolated from the urine of 21 urinary tract infection patients in three general hospitals in Hyogo Prefecture (Japan) were collected between 2007 and 2014. Their antibiotic susceptibilities, metallo-ß-lactamase screening test, metallo-ß-lactamase gene sequencing, multilocus sequence typing and repetitive-sequence-based polymerase chain reaction were determined for epidemiological analyses to investigate the genetic characteristics. RESULTS: Out of 21 isolates, 13 (61.9%) were positive for metallo-ß-lactamase. There were 11 (52.4%) isolates with IMP-1 in them, one (4.5%) isolate with IMP-7 and one (4.5%) isolate with VIM-1. Metallo-ß-lactamase-positive isolates were mainly identified as ST235, and metallo-ß-lactamase-negative isolates were STs 357, 277, 234, 439 and 639. Repetitive-sequence-based polymerase chain reaction showed metallo-ß-lactamase-positive isolates were grouped in eight clusters, and ST235 isolates with IMP-1 from three hospitals belonging to the identical group I, the other ST235 isolates with IMP-7 and VIM-1 were from two hospitals belonging to group II. CONCLUSIONS: Metallo-ß-lactamase-positive P. aeruginosa of ST235 isolates with IPM-1 were mainly identified from the urine of urinary tract infection patients in Hyogo, Japan. A ST235 isolate with VIM-1 was found for the first time. Further investigation is necessary to follow the spread of metallo-ß-lactamase-positive isolates.

A case of prostate stromal sarcoma involving the rectum.

Sarcomas and related proliferative lesions of the specialized stroma of the prostate are very rare and have been classified into prostate stromal sarcoma (PSS) and prostatic stromal tumor of uncertain malignant potential based on histology. We herein describe a case of PSS. A 40-year-old male presented at a hospital with urinary distention. Magnetic resonance imaging revealed a large prostate mass, and the diagnosis was prostate sarcoma of uncertain differentiation by ultrasound-guided needle biopsy. Total pelvic exenteration was performed and a pathological diagnosis of PSS was ultimately reached. Ten months later, there have been no signs of metastasis or recurrence.

Assessment of Time-dependent Changes in Semen Parameters in Infertile Men After Microsurgical Varicocelectomy.

OBJECTIVE: To characterize the changes in seminogram findings in infertile men after varicocelectomy. METHODS: This study included 71 consecutive infertile men who underwent microsurgical low ligation varicocelectomy and received 3 semen analyses, 1 before microsurgical varicocelectomy and again at 3 and 12 months after. Total motile sperm count (TMSC) was calculated using the following formula: [volume (mL) × concentration (millions/mL) × motility (%)]. RESULTS: Despite the lack of significant changes in the proportion of sperm with abnormal morphology, sperm concentration, motility, and TMSC in the 71 patients were significantly higher at 3 and 12 months after varicocelectomy than before surgery. However, no further improvement in these parameters at 12 months after varicocelectomy was noted compared with those at 3 months. Furthermore, when the included men were divided into 3 groups according to preoperative TMSC as <3 million, 3-9 million, and >9 million, TMSCs at 3 months after varicocelectomy in all 3 groups were significantly higher than those before varicocelectomy; however, TMSCs at 12 months after surgery in all groups were similar to those at 3 months. CONCLUSION: The level of improvement in semen parameters at 3 months after varicocelectomy may be stable at 12 months after surgery, irrespective of baseline values of TMSC. Therefore, varicocelectomy could be offered as a therapeutic option for infertile men, even for couples with an older woman, because its efficacy is evaluable at 3 months after surgery, and assisted reproductive technology could be immediately applied to ineffective cases.