Evaluation of the risk factors associated with the development of post-transurethral resection of the prostate persistent bacteriuria

Osman, Tarek; ElSaeed, Karim Omar; Youssef, Hassan A.; Shabayek, Mohamed; Emam, Ahmed; Hussein, Mohammed Saad

doi:10.1016/j.aju.2017.05.004

Cited by 14 publications

(15 citation statements)

References 17 publications

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“…Pre-operative positive bacterial urine culture was identified as a risk factor for developing post-operative fever (8.5% vs. 1.2%, RR = 3.85 range 1.33-100, P < 0.05). DM, indwelling urethral catheter and TURP combined with cystolithotripsy were reported by Osman et al, [7] as independent risk factors for bacteriuria, but did not increase the risk for post-operative fever in our cohort. This was ostensibly due to the strict following of preoperative antibiotic coverage in our practice, preventing bacteriuria from becoming bacteremia.…”

Section: Discussionsupporting

confidence: 69%

“…Due to our concern regarding record bias in accessing length of procedure, based on operation room registration in our cohort, we used prostate size as an indirect way of accessing operative time. Osman et al, reported prostate size larger > 60 cm 3 as a risk factor for UTI post-operatively [7]. In contrast, we found that smaller prostate size slightly increased the risk for post-operative fever with an RR of 1.06.…”

Section: Discussioncontrasting

confidence: 63%

“…Previous studies suggested that DM is a risk factor for postoperative UTI [7,11]. Our current data showed that 6.9% of the diabetic patients developed fever, compared to 4.2% of the nondiabetic patients (P = 0.48).…”

Section: Discussionsupporting

confidence: 49%

“…The rate of UTI after monopolar or bipolar TURP, ranges from 4.1-6.2% and 2.6-8.4%, respectively [6]. Osman et al, [7] reported some risk factors for persistent bacteriuria following TURP, including older age, previous history of diabetes mellitus (DM), large prostate size, positive preoperative bacterial urine culture, preoperative catheter use, previous urological interventions, large size of sheath, long duration of operation, postoperative catheter events, and postoperative manual wash. Furthermore, not all bacteriuria events following TURP present with fever, and therefore are under-reported.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors predicting fever following trans-urethral prostatectomy

Malshy¹,

Nativ²,

Sadeh³

et al. 2019

Journal of Molecular and Clinical Medicine

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Purpose: Fever occurring post transurethral resection of prostate (TURP) due to urinary tract infection (UTI) is a wellknown complication. A better knowledge of pre-operative risk factors will aid the prevention and treatment of this complication. Herein we aimed to describe the risk factors for postoperative fever in a cohort of patients undergoing TURP in a single institute. Methods: A total of 177 patients underwent transurethral resection of prostate (TURP) between January 2016 and August 2017 in our Institute. Postoperative fever was defined as ≥ 38 • C up to a week after surgery. Other reasons for post-operative fever were excluded. We collected data for indwelling catheter, antibiotic prophylactic treatment, positive preoperative urine culture, diabetes mellitus (DM), combined cystolithotripsy and prostate size. Results: All patients received antibiotic prophylaxis prior to the TURP procedure. Patients with negative urine culture were treated with IV Amikacin + Ampicillin (n = 83), whereas patients with positive bacterial cultures were treated as per antibiotic sensitivity profile (n = 93). One patient developed fever in the negative culture group, compared to 8 in the positive urine culture group (P = 0.0375). No patient developed septic shock. Smaller prostate size (RR = 1.06, CI-95%, 1.01-1.12, P = 0.016), positive urine culture (RR = 3.85, CI-95%, 1.33-100, P = 0.033) and older age (RR = 1.1, CI-95%, 1.01-1.21, P= 0.031) were all predictors of postoperative fever. In contrast, TURP combined with cystolithotripsy (P = 0.99), indwelling urethral catheter (P = 0.155), and patients with DM (P = 0.256) were not predictors of postoperative fever. Conclusions: Positive urinary bacterial culture prior to TURP is a frequent event. Although positive urinary culture increased the risk of post TURP fever, none of these events caused significant morbidity. Surprisingly, a smaller prostate size increased the risk of postoperative fever. This fact suggests that the degree of infection is attributed to the level of obstruction and not to the volume of the prostate.

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Section: Discussionsupporting

confidence: 69%

Section: Discussioncontrasting

confidence: 63%

Section: Discussionsupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors predicting fever following trans-urethral prostatectomy

Malshy¹,

Nativ²,

Sadeh³

et al. 2019

Journal of Molecular and Clinical Medicine

View full text Add to dashboard Cite

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“…Japanese guide about prevention of perioperative infection [9] and ORENUC system by EAU/ESIU classify those risk factors as: patient associated factors and procedure associated factors [5, 10]. Among all of them, ASA physical status classification, immunosuppression, indwelling catheter and catheterization duration after surgery have been identified as risk factors in our study.…”

Section: Discussionmentioning

confidence: 96%

Healthcare-Associated Infections after Lower Urinary Tract Endoscopic Surgery: Analysis of Risk Factors, Associated Microorganisms and Patterns of Antibiotic Resistance

et al. 2018

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Objectives: To review the incidence of healthcare-associated infections/urinary tract infection (UTI), risk factors, microorganisms isolated and antibiotic resistances in patients who underwent lower urinary tract endoscopic surgery (LUTES) in a tertiary care hospital. Methods: A prospective observational study was carried out including 1,498 patients who undergo LUTES. Patients with and without UTI after surgery were compared. We analysed infection incidence, risk factors, microorganisms isolated and antibiotic resistances. Results: Postoperative UTI incidence was 4.7%. Risk factors found: higher American Society of Anesthesiologists classification (OR 2.82; 95% CI 1.8–4.5; p < 0.00), immunosuppression (OR 2.89; 95% CI 1.2–7.2; p = 0.01), indwelling urinary catheter prior admission (OR 2.6; 95% CI 1.6–4.2; p < 0.00) and postoperative catheterization longer than 2 days (OR 1.74; 95% CI 1.7–4.3; p < 0.00). Transurethral resection of the bladder (TURB) had the highest infection rates (5.5%). Microorganisms isolated were Pseudomonas aeruginosa (23.5%), Escherichia coli (17.6%), Klebsiella pneumoniae and Enterococcus spp (11.8%). Resistance rates for flourquinolones varied between 28 and 80%, and Carbapenem-resistant Enterobacteriaceae rose up 20%. Conclusions: Low percentage of UTI after endoscopic surgery was registered. TURB was the procedure with highest infection rate. Pseudomonas aeruginosa stands out as the most frequently isolated microorganism. Patient comorbidities, previous urinary catheter and postoperative catheter were identified as risk factors.

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