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    Antimicrobial resistance in urosepsis: outcomes from the multinational, multicenter global prevalence of infections in urology (GPIU) study 2003-2013
    (Springer, 2016) Tandogdu, Zafer; Bartoletti, Ricardo; Cai, Tomasso; Cek, Mete; Grabe, Magnus; Kulchavenya, Ekaterina; Koves, Bela
    Primary objective was to identify the (1) relationship of clinical severity of urosepsis with the pathogen spectrum and resistance and (2) appropriateness of using the pathogen spectrum and resistance rates of health-care-associated urinary tract infections (HAUTI) as representative of urosepsis. The secondary objective was to provide an overview of the pathogens and their resistance profile in patients with urosepsis. A point prevalence study carried out in 70 countries (2003-2013). Population studied included; 408 individuals with microbiologically proven urosepsis, 1606 individuals with microbiological proof of HAUTI and 27,542 individuals hospitalised in urology wards. Main outcomes are pathogens and resistance identified in HAUTIs and urosepsis including its clinical severity. A statistical model that included demographic factors (study year, geographical location, hospital setting) was used for analysis. Amongst urology practices, the prevalence of microbiologically proven HAUTI and urosepsis was 5.8 and 1.5 %, respectively. Frequent pathogens in urosepsis were E. coli (43 %), Enterococcus spp. (11 %), P. aeruginosa (10 %) and Klebsiella spp. (10 %). Resistance to commonly prescribed antibiotics was high and rates ranged from 8 % (imipenem) to 62 % (aminopenicillin/beta lactamase inhibitors); 45 % of Enterobacteriaceae and 21 % of P. aeruginosa were multidrug-resistant. Resistance rates in urosepsis were higher than in other clinical diagnosis of HAUTI (Likelihood ratio < 0.05). It is not appropriate to use the pathogen spectrum and resistance rates of other HAUTIs as representative of urosepsis to decide on empirical treatment of urosepsis. Resistance rates in urosepsis are high, and precautions should be made to avoid further increase.
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    The Global Prevalence of Infections in Urology (GPUI) Study: A Worldwide Surveillance Study in Urology Patients
    (Elsevier, 2016) Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo; Cai, Tommaso; Cek, Mete; Kulchavenya, Ekaterina; Koves, Bela
    [Abstract Not Available]
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    The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections
    (Mdpi, 2016) Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo; Cai, Tommaso; Cek, Mete; Kulchavenya, Ekaterina; Koeves, Bela
    The Global Prevalence of Infections in Urology (GPIU) study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI). Investigators registered data through a web-based application (http://gpiu.esiu.org/). Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years.
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    The therapy for urogenital tuberculosis
    (Marmara Univ, Fac Medicine, 2023) Kulchavenya, Ekaterina; Cek, Mete
    Tuberculosis (TB) is a communicable disease that is a major cause of ill health. Urogenital TB was a frequent urological disease in the pre-antibiotic era: about 20% of patients in urological hospitals had renal TB, mostly in the form of pyonephrosis. We composed a narrative review of the literature with keywords urogenital tuberculosis', prostate tuberculosis kidney tuberculosis, treatment of tuberculosis.Urogenital TB (UGTB) includes TB of the kidney and the urinary tract and male and female genital TB. Each clinical presentation requires tailored antibiotic therapy depending on stage and general management. Anti-TB therapy should be multicomponent, continuous, long-lasting and controlled with a follow-up for 2-3 years. Otherwise, the risks of development of drug-resistance and relapse increase.Index of suspicion on UGTB is generally low, causing a delay in diagnosis; consequently, complicated forms of UGTB respond poorly to anti-TB therapy, while timely diagnosed minor forms are curable medically without surgery. Even with timely diagnosed UGTB, non-optimal therapy may result in over-fibrosis, scarring and strictures of the urinary tract, making surgical repair inevitable. Nevertheless, we have a wide enough spectrum of anti-TB drugs to cure urogenital TB.