title: A study of the bacterial flora before and after antiseptic skin preparation of the perineum in male urology patients.
abstract: OBJECTIVE
  To establish the bacterial flora of the perineum before and after antiseptic preparation in male urology patients.
  
  
  METHODS
  Adult male patients undergoing cystoscopic procedures were studied. Three sets of swab specimens, labelled A, B and C, were taken from the perineum in the theatre. Specimen A was taken before cleaning and disinfection of the skin with Savlon (Chlorhexidine- cetrimide mixture), specimen B after disinfection and draping, and C after completion of the operative procedure. Specimens were processed on standard laboratory media for aerobic and anaerobic bacteria and yeasts.
  
  
  RESULTS
  Of the 114 patients studied, 43 (37.7%) had a positive culture for significant microorganisms in specimen A, 7 (6.1%) in specimen B and 13 (11.4%) in specimen C (A vs. B p < 0.001, A vs. C p < 0.001, B vs. C p < 0.01). The commonest isolates in specimen A were Gram-positive organisms (84.1%). The positive-culture rate for patients with end-stage renal failure was 71.4%, for those with a urethral catheter it was 53.8%, for those without systemic diseases it was 36.6% and for patients with diabetic mellitus it was 28.1%.
  
  
  CONCLUSIONS
  About 38% of patients undergoing cystoscopic procedures had a significant positive perineal culture, with Staphylococcus species being the predominant skin flora. The bacteria culture rate was affected by the presence of systemic diseases. The use of Savlon to disinfect the perineum resulted in a significant reduction in the bacterial count of the perineum.
authors.affiliation: Department of Surgery (Division of Urology), Faculty of Medicine, Kuwait University, Safat, Kuwait. ekehinde@hsc.edu.kw
authors.forename: Elijah O
authors.initials: EO
authors.lastname: Kehinde
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ali
authors.forename: Fathima
authors.initials: F
authors.lastname: Khodakhast
authors.forename: Wafaa Y
authors.initials: WY
authors.lastname: Jamal
authors.forename: Mohammed
authors.initials: M
authors.lastname: Seshah
authors.forename: Vincent O
authors.initials: VO
authors.lastname: Rotimi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D003558:Cystoscopy / Q000009:adverse effects*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000382:microbiology* / Q000473:pathology; D012867:Skin / Q000382:microbiology*; D014572:Urology / Q000379:methods*
chemical_list: D000891:Anti-Infective Agents, Local