No abstract

We assessed the antimicrobial resistance patterns of all urine samples submitted for culture from outpatient women aged ≥14 years with diagnosis of uncomplicated cystitis over a 24-month period (2007-2009) in the city of Fortaleza, Brazil. Only bacterial growth of a single uropathogen with ≥10(5) CFU/mL was considered for analysis. The Pearson's chi-square test was used for bivariate correlations. Escherichia coli presented the highest prevalence (64.7%). Coagulase-negative staphylococcus was more common in younger than in older women (P = 0.003). Gentamicin presented the lowest overall resistance pattern (3.5% resistant), followed by ceftriaxone (5%) and norfloxacin (7.5%). Ampicillin and trimethoprim-sulfamethoxazole were the least active agents with 63.7% and 39.8% of resistance, respectively. The resistant rate to trimethoprim-sulfamethoxazole was significantly higher among E. coli than non-E. coli isolated. Among ciprofloxacin-resistant E. coli strains, only 3.4% were resistant to nitrofurantoin. We conclude that trimethoprim-sulfamethoxazole follows a worldwide tendency of antimicrobial increasing resistance and it should be avoided as first-line empirical treatment for urinary tract infections.

No abstract

Purpose:To analyze the association between obesity and urinary incontinence rate in men submitted to robot-assisted radical prostatectomy (RARP) in a high-volume cancer center. Materials and Methods: We reported 1.077 men who underwent RARP as the primary treatment for localized prostate cancer from 2013 to 2017. Patients were classifi ed as non-obese (normal BMI or overweight) or obese men (BMI ≥30kg/m 2 ). They were grouped according to the age, PSA level, D'Amico risk group, Gleason score, ASA classifi cation, pathological stage, prostate volume, salvage/adjuvant radiotherapy, perioperative complications, and follow-up time. Urinary continence was defi ned as the use of no pads. For the analysis of long-term urinary continence recovery, we conducted a 1:1 propensity-score matching to control confounders. Results: Among the obese patients, mean BMI was 32.8kg/m 2 , ranging 30 -45.7kg/m 2 . Only 2% was morbidly obese. Obese presented more comorbidities and larger prostates. Median follow-up time was 15 months for the obese. Complications classifi ed as Clavien ≥3 were reported in 5.6% of the obese and in 4.4% of the non-obese men (p=0.423). Median time for continence recovery was 4 months in both groups. In this analysis, HR was 0.989 for urinary continence recovery in obese (95%CI=0.789 -1.240; p=0.927). Conclusions: Obese can safely undergo RARP with similar continence outcomes comparing to the non-obese men when performed by surgeons with a standardized operative technique. Future studies should perform a subgroup analysis regarding the association of obesity with other comorbidities, intending to optimize patient counseling.