[Urinary bacteriologic study prior to endoscopic urologic surgery].
OBJECTIVE
The objectives of this study are to know the incidence of preoperative bacteriuria in patients undergoing endoscopic urologic surgery, to analyze the most frequent microorganisms appearing in the cultures and their resistance to antibiotics in order to select the most appropriate prophylactic one for our population, and to determine the risk factors related to postoperative bacteriuria or sepsis of urologic origin.


METHODS
449 patients undergoing endoscopic urologic surgery were included in the study. Urinary samples were collected for culture prior to prophylactic antibiotic administration and again a week after bladder catheter removal once the antibiotic treatment was finished. Variables related to an increase in infectious complications were analyzed. Special attention was paid to postoperatory incidences, mainly those of infectious nature.


RESULTS
Preoperative bacteriuria was found in 66 out of 428 patients (15.4%). It was found to be related to age, sex, previous infection episodes, diabetes mellitus, indwelling catheter and to the pathology for which operation was indicated. The most frequently found microorganism was Escherichia Coli. Resistance to prophylactic antibiotic was found in 37.9% of patients with preoperatory bacteriuria. Postoperatory bacteriuria, observed in 22.0% of the patients was exclusively related to preoperatory bacteriuria. 2.9% of patients showed sepsis of urinary origin criteria during hospital staying, and it was found to be exclusively related to length of surgery and neither to preoperatory bacteriuria nor to indwelling catheter time or the "inappropriate" prophylactic antibiotic use in these cases.


CONCLUSIONS
A good part of patients who underwent endoscopic surgery showed preoperatory bacteriuria, responsible for postoperative bacteriuria in less than 25% of the cases. The length of surgery seemed to be the only related cause whit sepsis of urinary origin.
Menéndez López
V
V
Servicio de Urología, Hospital General Universitario de Elche, Alicante. violetamenendez@wanadoo.es
Galán Llópis
J Antonio
JA
Elía López
M
M
Carro Rubias
C
C
Collado Serra
A
A
de Paz Cruz
L
L
García López
F
F
D000368:Aged; D001437:Bacteriuria / Q000175:diagnosis / Q000382:microbiology*; D003558:Cystoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D018666:Ureteroscopy / Q000009:adverse effects*; D014551:Urinary Tract / Q000382:microbiology / Q000601:surgery; D014556:Urine / Q000382:microbiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods