BackgroundTo evaluate the antibiotic resistance patterns of uropathogens isolated from adult women with acute community-acquired (CA) uncomplicated cystitis.ResultsOver a one-year period (May 2015–April 2016), the results of susceptibility testing of outpatient midstream urine samples from 5 different laboratories were prospectively evaluated. The study included only adult women with uncomplicated cystitis. The susceptibility testing in all laboratories was performed using the disk diffusion method with the VITEK-2 Compact system. The isolated uropathogens and their resistance to the tested antibiotics were evaluated. Out of 317 adult women with CA uncomplicated cystitis, 179 had a positive culture. The most commonly isolated organism was Escherichia coli (E. coli) (70.4%), followed by Klebsiella (21.2%). The overall resistance rate was highest for ampicillin (85.6%), followed by cefalotin (56.3%), trimethoprim/sulfamethoxazole (54.7%), pipracillin (51.9%), nitrofurantoin (48.8%) and aztreonam (47.4%). Isolated E. coli strains were commonly resistant to ampicillin (80.5%), trimethoprim/sulfamethoxazole (72.2%) and aztreonam (71.4%), followed by cefalotin (55.9%). The overall ciprofloxacin resistance rate was 17.9%, and the resistent was found only with E. coli (25.4%).ConclusionsOur results may aid in the selection of proper empiric antibiotic therapy for adult women with acute CA uncomplicated cystitis.

Introduction: Prostatic artery embolization (PAE) has recently started to be viewed as a promising technology that could be an alternative to different treatment options of benign prostatic hyperplasia (BPH), especially in high-risk patients. The aim of our study was to evaluate the efficacy and safety of PAE in BPH patients who are at high risk for surgery and/or anesthesia. Materials and Methods: Between June 2013 and February 2015, BPH patients >50 years with lower urinary tract symptoms (LUTS) refractory to BPH-related medical therapy or had an indwelling urethral catheter due to refractory urine retention were prospectively enrolled in the study. All patients were at high risk for surgery and/or anesthesia. The PAE was performed and the embolising material used was biosphere 300-500 µm particles. Pre- and 1, 3, 9 months post-intervention, all patients were assessed by detailed medical history, physical examination, serum prostate-specific antigen (PSA), uroflowmetry, and abdominal and transrectal ultrasonography. Results: Twenty-two consecutive patients with a mean age of 72.50 years and a mean prostate volume of 77.30 ± 14.89 cm³ were included. The PAE procedure was successful in all patients. Throughout the period of follow-up, there was a significant improvement in the LUTS and urinary flow rate, and reduction in prostate volume and serum PSA (for all p < 0.001). No major complications were reported. Conclusion: Our results show that BPH patients with failed medical treatment who are at high risk for surgery and/or anesthesia could be treated safely and effectively through PAE.

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IntroductionAcute perforations are one of the recognised complications of both diagnostic and therapeutic gastrointestinal endoscopy. For decades, surgical treatment has been the standard of care, but endoscopic closure has become a more popular approach, due to feasibility and the reduction of the burden of surgery, combined with the availability of various endoscopic closure devices.We aimed to assess the technical and clinical success and safety of endoscopic closure, in total, and for each endoscopic device used in closing acute perforations in animal models.MethodMedical literature (Cochrane library, EMBASE, MEDLINE) from 1966 till September 2016 was searched. A systematic review and meta-analysis were performed on studies reporting technical and clinical success of endoscopic closure of acute perforations, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines.Results46 studies on animal models were identified. 15 studies,including 4 randomised controlled trials, met our inclusion criteria (acute, less than 24 hours, iatrogenic, no fistulas or leaks, clear documentation of the method of closure, and technical and clinical success and 5 cases or more of endoscopic closure per study), were analysed. A total of 214 endoscopic closures were attempted in these studies. The overall technical success rate was 94.8% (n=201/214, 95% CI: 92%>97.6%), clinical success was 92.3% (n=189/214, 95% CI: 88.8%>95.8%), and complication rate was 4.2% (n=6/214, 95% CI: 1.6%>6.8%).Technical success for endoclip closure was 84.9% (95% CI: 71.4%>93.6%), and clinical success was 83.2% (95% CI: 69.5%>92.5%), and complication rate was 2.7% (95% CI: 90.12%>99.88%).For OTSC (Over the scope clip device), technical success was 97% (95% CI: 88%>99.7%), clinical success was 97% (95% CI: 88%>99.7%), and complication rate was 1.87% (95% CI: 91.2%>98.8%).The technical success for endosuturing (endoscopic suturing device) was 92.7% (95% CI: 82% to 98%), clinical success was 87% (95% CI: 74.9%–94.8%), complication rate was 1.9% (95% CI: 91.1%>98.9%).ConclusionOur study suggests that endoscopic closure is a suitable treatment option for acute iatrogenic gastrointestinal perforations with a reasonable technical and clinical success, and low complication rate. Further confirmation from prospective studies in human is needed.Disclosure of InterestNone DeclaredAbstract PTH-009 Figure 1

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acting opioids with benzodiazepines, long-acting opioids with benzodiazepines, and short-acting opioids with propofol. The primary outcome was the frequency of cardiorespiratory events, defined as intra-procedural episodes of hypotension or hypoxemia. We conducted a random-effects Bayesian network meta-analysis using Markov Chain Monte Carlo simulation methods to generate risk ratios and 95% credible intervals for each sedative comparison. We plotted cumulative ranking probabilities based on the direct and indirect estimates generated by the network. Results: We identified 20 studies, including 2,277 patients, directly comparing the cardiorespiratory events between sedatives of interest. Cardiorespiratory events were rare across all sedatives and sedative combinations. Long-acting opioids used with benzodiazepines were associated with a greater risk of cardiorespiratory events than short-acting opioids used alone (RR 3.73; 95% CrI: 1.14-15.15). We did not find any other significant differences in the risk of cardiorespiratory events between the various sedative combinations evaluated; however, there was a trend towards greater events when long-acting opioids with benzodiazepines were compared to all other sedative combinations and fewer events when short-acting opioids were compared to all sedative combinations (Table ). Ranking probabilities demonstrated short-acting opioids used alone to have the highest probability of being the safest sedative and long-acting opioids used with benzodiazepines to have the highest probability of being the least safe sedative combination. Conclusions: The frequency of adverse cardiorespiratory events among the sedatives commonly used in colonoscopy is low. Propofol and non-propofol sedative combinations demonstrate similar cardiorespiratory risk profiles, suggesting equivalent safety when used in this setting.