Development of antibiotics resistance condition has been at a concerning state while data on the distribution of bacterial profile and the incidence of resistances in Indonesia are currently still limited at hospital environment, including at Prof. Dr. R. D. Kandou Hospital in Manado, Indonesia. This study aimed to obtain the profile of bacteria and the pattern of susceptibility to antibiotics in patient's urine before and after urologic endoscopy procedures at RSUP Prof. Dr. R. D. Kandou. This was an observational study with a cross sectional design. Sampling was performed with the one-group test technique of Lemeshow. The data collection technique used urine culture test by calculating the percentages. The results obtained 42 patients as subjects. The urinary bacterial profile of patients who underwent urologic endoscopy procedures at Prof. Dr. R. D. Kandou Hospital were dominated by Gram-negative bacteria, namely E. coli (23.8%), Klebsiella (4.8%), Acinetobacter baumannii (2.4%); 69% of urine samples showed negative culture results. The susceptibility pattern of bacteria to antibiotics in the subjects’ urine showed 100% sensitivity to the given antibiotics. No nosocomial infection was found, however, nosocomial infection yet could not be excluded. In conclusion, bacteria found in the patients’ urine are dominated by Gram-negative bacteria namely Escherichia coli, Klebsiella, and Acinetobacter baumannii which are still sensitive to antibiotics. Most urine samples showed negative results, and no nosocomial infection was found.Keywords: bacterial profile; bacterial susceptibility; antibiotic; urological endoscopic procedure

Fournier’s gangrene is a form of necrotizing fasciitis that begins in the genital and perineal areas and can extend through the fascia to the groin, thigh, and even the abdominal wall. This disease is still associated with a high mortality rate even though with comprehensive therapy. Simple examination, such as a complete blood count, is widely used as a marker of inflammation and could be used as a prognostic factor for Fournier’s gangrene. This study aimed to compare Fournier Gangrene Severity Index (FGSI) and complete blood count as a prognostic factor in Fournier’s gangrene cases by using machine learning. This was an observational study with a longitudinal data collection design according to cohort method. The results obtained 30 patients with Fournier’s gangrene at Prof. Dr. R. D. Kandou Hospital, Manado. Mortality prediction analysis using algorithms of regularized generalized linear model (GLM) and support vector machine (SVM) showed that the AUCs were 98% and 97.5% for GLM and SVM respectively for the regularized GLM and SVM in the ROC curve analysis, with the superiority to the FGSI (p<0.001). In conclusion, the complete blood count could be used as a novel prognostic value of Fournier’s gangrene cases.Keywords: complete blood count; Fournier Gangrene Severity Index (FGSI); prognostic scoring system; Fournier’s gangrene Abstrak: Gangren Fournier adalah bentuk fasiitis nekrotikans yang dimulai di daerah genital dan perineum dan dapat meluas melalui fasia ke selangkangan, paha, dan bahkan dinding perut. Penyakit ini masih dikaitkan dengan angka kematian yang tinggi meskipun dengan terapi komprehensif. Pemeriksaan sederhana seperti hitung darah lengkap, banyak digunakan sebagai penanda peradangan dan dapat digunakan sebagai faktor prognostik untuk gangren Fournier. Penelitian ini bertujuan untuk membandingkan Fournier Gangrene Severity Index (FGSI) dengan pemeriksaan parameter hitung darah lengkap sebagai faktor prognostik pada kasus dengan gangren Fournier menggunakan machine learning. Jenis penelitian ialah observasional dengan desain pengumpulan data longitudinal menurut metode kohort. Hasil penelitian mendapatkan 30 pasien dengan gangren Fournier di RSUP Prof. Dr. R. D. Kandou Manado. Analisis prediksi mortalitas menggunakan algoritma Regularized Generalized Linear Model (GLM) dan Support Vector Machine (SVM) menunjukkan bahwa AUC masing-masing sebesar 98% dan 97,5% untuk GLM dan SVM tereguler pada analisis kurva ROC, dengan keunggulan dibandingkan FGSI (p<0,001). Simpulan penelitian ini ialah pemeriksaan darah lengkap dapat dijadikan sebagai faktor prognostik baru untuk kasus gangren Fournier.Kata kunci: hitung darah lengkap; Fournier Gangrene Severity Index (FGSI); sistem skoring prognostik; gangren Fournier

Background: The treatment of choice for bladder stones in children remains debatable. This study aimed to compare the outcomes of endourological and open cystolithotomy for the management of bladder stones in children. Methods: The Medline, Embase, Cochrane controlled trial databases and clinicaltrials.gov were searched for relevant English-language publications from 1 to 30 August 2022. Stone-free rate (SFR), complication rate, length of stay, and procedure duration were compared. Children (male and female) <18 years of age of any ethnicity with bladder stones (single/multiple) were included. Patients with a history of bladder augmentation or diversion were excluded. The quality of studies included was assessed using Cochrane’s Risk of Bias Assessment. The meta-analysis was performed using RevMan. Results: Five articles (436 participants) that compared endourological versus open cystolithotomy were included in qualitative and quantitative analyses. Four were non-randomised, retrospective, and single centre studies. While the other one was a randomised controlled trial. Measure outcome characteristics included SFR, complications, procedure duration, and length of hospital stay. There was no significant difference in the SFR between transurethral cystolithotripsy (TUCL) and percutaneous cystolithotomy (PCCL) (p=0.22). There were also no significant differences in complications (TUCL versus PCCL, p=0.18; TUCL versus open cystolithotomy [CL] and PCCL versus CL, p=0.08). PCCL featured a longer procedure duration than TUCL (p<0.00001), while CL was shorter than TUCL and PCCL (both p<0.00001). Finally, in terms of length of stay, TUCL was superior to PCCL and CL, while PCCL was better than CL (all p<0.00001). Conclusions: Endourological and open surgical management of bladder stones in children showed comparable SFR and fewer complications. Open surgery offers a shorter procedure duration than endourological management, but PCCL features a shorter procedure duration than TUCL. In terms of length of stay, TUCL and PCCL were superior to CL, while TUCL was better than PCCL.