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Introduction: We retrospectively investigated the risk factors for post-urodynamic study (UDS) infectious complications in long-term hospitalized inpatients with suspected neurogenic lower urinary tract disturbance (NLUTD) in a monocenter study, to accurately assess post-UDS urinary tract infections (UTI). Methods: We retrospectively analyzed data including background information, UDS-related data, and potential risk factors for infection from 489 NLUTD-suspected inpatients who underwent UDS from 2015 to 2019 and examined the risk factors for post-UDS infectious complications using univariate and multivariate statistical analyses. Results: Symptomatic post-UDS UTI occurred in 20 out of 489 (4.1%) patients, including 3 (15%) with recurrent UTI. During follow-up prior to UDS for 1 year, 220 cases were investigated by urine culture revealing Escherichia coli (n = 77), Klebsiella pneumoniae (n = 29), Enterococcus faecalis (n = 18), extended-spectrum beta-lactamase-producing E. coli (n = 17), and Pseudomonas aeruginosa (n = 9). As risk factors for post-UDS infectious complications, American Spinal Injury Association impairment scale (AIS): AIS ≧ C (A or B or C) (hazard ratio: 4.29, p = 0.0076), management method of urination (hazard ratio: 4.30, p = 0.048), and age (hazard ratio: 1.04, p = 0.025) were significantly correlated with the occurrence of post-UDS infection. Conclusions: The significant risk factors for post-UDS UTI were AIS ≧ C, management method of urination, and age in the suspected NLUTD patient context. This study was originally started with the goal of reducing unnecessary antibiotics and may contribute to the proper use of antibiotics based on antimicrobial stewardship.

Objectives: To compare antibiotic susceptibilities between chromosomal and plasmid bla CTX-M-15 locations in urinary tract infection-causing extended-spectrum b-lactamasesproducing Escherichia coli bla CTX-M-15 isolated in Indonesia. Methods: A total of 84 strains identified as extended-spectrum b-lactamases-producing E. coli were isolated from patients with urinary tract infection in Indonesia in 2015. Antimicrobial susceptibility tests were performed on these strains using 18 antibiotics, and extended-spectrum b-lactamase bla genes were detected by polymerase chain reaction. Gene localization of bla CTX-M-15 -positive strains was confirmed by Southern blot hybridization, and epidemiological typing was conducted using multilocus sequence typing. Results: Of 54 strains harboring the bla CTX-M-15 gene, 27 showed localization on chromosome, 20 on plasmid, and seven on chromosome and plasmid. Most multilocus sequence typing sequence types of the 27 strains with chromosomal bla CTX-M-15 were ST405 (25.9%) and ST131 (22.2%) strains, whereas the 20 strains with plasmid-bla CTX-M-15 were mostly ST410 (55.0%). Conclusions: Extended-spectrum b-lactamases-producing E. coli bla CTX-M-15 with plasmid genes show significantly higher resistant rates against piperacillin-tazobactam but lower resistant rates against chloramphenicol compared to chromosomal strains in Indonesian patients with urinary tract infection. Mechanistic investigations will be necessary to advance our knowledge of antimicrobial resistance in urinary tract infection.

Encrustation, caused by deposition of calcium and magnesium salts present in urine, is a common problem of indwelling urinary devices, such as ureteral stent. Encrustation was also found to be related to urinary tract infections; thus, it is necessary to prepare ureteral stents with antibacterial and antifouling surfaces to mitigate the occurrence of encrustation. In this study, commercial ureteral stent was coated with polydopamine (PDA), formed from self‐polymerization of dopamine. The PDA coating was optimized in terms of dopamine concentration, pH, and coating time using response surface methodology. The chosen response parameters for optimization were calcium oxalate (CaC2O4) encrustation and protein adsorption. Optimized PDA coating conditions were determined to be the following: pH 9.0, 2 mg/mL DA, and 3 days coating. The optimized PDA‐coated ureteral stent exhibited outstanding resistance against CaC2O4 encrustation, protein fouling, and bacterial adhesion due to its hydrophilic and functional coating layer. In comparison with the pristine ureteral stent, PDA coating was able to suppress approximately 97% and 87% of CaC2O4 and protein adsorption, respectively. The PDA‐coated ureteral stent was compared against those of commercially available ureteral stents and found to have superior encrustation and protein fouling mitigation performance. Finally, PDA coating was found to be highly stable for a storage period of 90 days, whether stored in wet or dry conditions.

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