Prevention of Infectious Complication and Its Risk Factors after Urological Procedures of the Upper Urinary Tract

Matsumoto, Minori; Shigemura, Katsumi; Yamamichi, Fukashi; Tanaka, Kazushi; Nakano, Yuzo; Arakawa, Soichi; Fujisawa, Masato

doi:10.1159/000332224

Cited by 16 publications

(12 citation statements)

References 21 publications

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“…No findings in regard to the type of AMP for these cases has been reported, though many reports have noted that the most common causative bacterium was Escherichia coli , followed by Enterococcus species and Pseudomonas aeruginosa , thus antimicrobials targeting those bacteria should be selected, such as penicillins with BLIs, first‐ or second‐generation cephalosporins, aminoglycosides, or quinolones (EL, III; RG, B) …”

Section: Detailed Exposition 3: Transurethral Examination or Surgery mentioning

confidence: 99%

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

Yamamoto

Shigemura

Kiyota³

et al. 2016

Int J of Urology

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After publication of the initial version of the Japanese guidelines for urological surgery in 2007, new surgical techniques have been introduced. Furthermore, several important issues, such as criteria for use of single-dose antimicrobial prophylaxis and control of hospitalized infection, were also established, which led to alterations of the methods used for antimicrobial prophylaxis as well as perioperative management. The purpose of antimicrobial prophylaxis is to protect the surgical wound from contamination by normal bacterial flora. Antimicrobial prophylaxis should be based on penicillins with beta-lactamase inhibitors, or first-or second-generation cephalosporins, though penicillins without beta-lactamase inhibitors should not be prescribed because of the high prevalence of antimicrobial resistance. As an adequate intratissue concentration of the antimicrobial at the surgical site should be accomplished by the time of initiation of surgery, antimicrobial prophylaxis should be started up to 30 min before beginning the operation. Antimicrobial prophylaxis should be terminated within 24 h in clean and clean-contaminated surgery, and within 2 days of surgery using the bowels, because a longer duration is a risk factor for surgical site infection development. Importantly, possible risk factors for surgical site infections include the antimicrobial prophylaxis methodology used as well as others, such as duration of preoperative hospitalization, hand washing, the American Society of Anesthesiologists score, diabetes and smoking history. These guidelines are to be applied only for preoperatively non-infected low-risk patients. In cases with preoperative infection or bacteriuria that can cause a surgical site infection or urinary tract infection after surgery, patients must receive adequate preoperative treatment based on the individual situation.

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Section: Detailed Exposition 3: Transurethral Examination or Surgery mentioning

confidence: 99%

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

Yamamoto

Shigemura

Kiyota³

et al. 2016

Int J of Urology

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“…He examined 20.9% patients with preoperative bacteriuria, and 10.8% of these patients had infective complications (p=0.000). Matsumoto in his study also concluded the preoperative bacteriuria was a statistically significant risk factor for occurrence of infective complications following urologic procedures in the upper urinary tract (18). Blackmur in his analyses of risk factors for developing sepsis following ureteroscopic lithotripsy, which was done with 462 patients, published that 34 (7.4%) patients had sepsis and that positive preoperative findings of urine culture were associated with occurrence of postoperative urosepsis, although an adequate antibiotic preoperative therapy was applied (p<0.001) (15).…”

Section: Discussionmentioning

confidence: 92%

Postoperative urinary tract infection after ureteroscopic lithotripsy in patients with asymptomatic bacteriuria

Šuljagić

Bančević

2020

VOJNOSANIT PREGL

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Background/Aim. Postoperative urinary tract infection is one of the most common infective complications of ureteroscopic lithotripsy. Preoperative asymptomatic bacteriuria is not a contraindication for performing ureteroscopic lithotripsy but it can be a significant risk factor for occurence of severe forms of postoperative urinary infection. Methods. From January 2010 until December 2014 at the Urology Clinic of the Military Medical Academy 389 patients undergoing ureteroscopic lithotripsy were analyzed, and their postoperative infective complications were monitored. From the group, by means of chisquared test (X 2), the incidence of posteoperative urinary infection was analysed in 52 patients with preoperative asymptomatic bacteriuria. Results. Infective complications occured in 18.7% of patients, and postoperative urinary tract infection in 10% of patients. Out of 52 patients with preoperative asymptomatic bacteriuria, 36.5% had postoperative urinary tract infection (X 2 =46.773) (p<0.001). Discussion. The incidence of a postoperative urinary tract infection following ureteroscopic lithotripsy in our study is 10%, and total percentage of all infective complications is 18.7% which correlate with referent studies showing the percentage of infective complications from 1.7 to 18.3%. Different incidence of infective complications between studies is explained by the fact that a standardised system for registering these complications does not exist yet. In our study, of 36.5% patients that preoperatively had asymptomatic bacteriuria, we registered higher frequency of severe forms of postoperative urinary tract infection, SIRS and sepsis. Conclusion. Preoperative asymptomatic bacteriuria represents a significant risk factor for developing postoperative urinary tract infection following ureteroscopic lithotripsy and is associated with increased risk for occurence of severe forms of SIRS and sepsis. It is desirable that every patient with indicated ureteroscopic lithotripsy has sterile urine culture, and if this is impossible to achieve, a special caution and an adequate antibiotic therapy and prophylaxis are needed in these patients before and during the surgical procedure.

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“…These include advanced age, diabetes, bladder dysfunction, indwelling catheter, calculi, ureterointestinal anastomosis, previous manipulation, and bacteriuria. 19,28,31,32 Cochran et al 31 demonstrated that in patients with risk factors, the risk of sepsis was 50% without prophylaxis compared to 9% when prophylaxis was given. They found no statistically significant difference in patients without risk factors, although this may have been due to the small sample size (n ¼ 24).…”

Section: Percutaneous Nephrostomy (Pcn)mentioning

confidence: 99%

“…32 The most common indication for transrectal biopsy is transrectal ultrasound (TRUS) prostate biopsy. The majority of infections occur within the first week following the procedure, and the most common organism isolated on urine and blood cultures is Escherichia coli.…”

Section: Percutaneous Biopsymentioning

confidence: 99%

Antibiotics in interventional radiology

et al. 2015

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Prevention of Infectious Complication and Its Risk Factors after Urological Procedures of the Upper Urinary Tract

Cited by 16 publications

References 21 publications

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

Postoperative urinary tract infection after ureteroscopic lithotripsy in patients with asymptomatic bacteriuria

Antibiotics in interventional radiology

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