Hospital acquired pre-prostatectomy bacteriuria: risk factors and implications.
One hundred and one consecutive prostatic patients with sterile urines were prospectively studied for the risk factors involved in the hospital acquired pre-prostatectomy bacteriuric and its implications. Eleven out of 101 patients (11%) became bacteriuric at operation whereas ninety of 101 patients (89%) remained abacteriuric. Nine of the eleven bacteriuric patients (82%) had pre-operative indwelling urethral catheters compared to 37/90 (41%) abacteriurics (P < 0.05). Mean catheter duration was 22.22 and 9.92 days respectively (P < 0.05). Three out of eleven (27%) bacteriuric patients had chronic retention of urine compared to one of ninety (1%) abacteriuric patients. Past history of acute retention, vesical stones, vesical diverticulae, diabetes mellitus and azotaemia were not significant risk factors. Post-operative fever did not correlate with positive blood cultures. However, eight of the eleven (73%) bacteriurics developed bacteraemia compared to only one out of ninety (1%) abacteriuric patients. It is concluded that the significant risk factors which would be strong indications for antimicrobial prophylaxis in prostatectomy are chronic retention of urine and prolonged pre-operative indwelling urethral catheterization for more than ten days. Azotaemia, diabetes mellitus and associated bladder pathologies were not significant and therefore do not warrant antimicrobial prophylaxis.
Ibrahim
A I
AI
Department of Surgery, College of Medicine, King Saud University, Abba, Saudi Arabia.
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001437:Bacteriuria / Q000209:etiology*; D002908:Chronic Disease; D003428:Cross Infection / Q000209:etiology*; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000009:adverse effects*; D011446:Prospective Studies; D011468:Prostatectomy; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects*; D016055:Urinary Retention / Q000150:complications*