title: Postoperative bacteriuria, pyuria and urinary tract infection in patients with an orthotopic sigmoid colon neobladder replacement.
abstract: The purpose of this study is to investigate the prevalence of postoperative bacteriuria, pyuria and urine culture in patients with an orthotopic sigmoid colon neobladder replacement. Urine samples for bacteriuria, pyuria and urine culture, if necessary, were collected at 1, 3, 6, 9 and 12 months after surgery and the presence of blood culture and antibiotic-resistant strains, and their treatments on positive urine culture cases were investigated. Of 209 for bacteriuria and 207 for pyuria urine samples with evaluable data, 95 (45.5%) were positive for bacteriuria and 76 (36.7%) had pyuria (10 or more white blood cells per high-power field). Totally, 30 bacteria were isolated from urine culture of urinary tract infection (UTI) and Klebisiella pneumoniae, Escherichia coli, Staphylococcos aureus and Enterococcus spp. strains were representatively isolated. The incidence of pyuria significantly decreased over time (P=0.041) but that of bacteriuria did not (P=0.107). In them, there were six bacteria (20.7%) with antibiotic-resistant strains. The antibiotics used for their treatments representatively were levofloxacin in five cases, tazobactam/piperacillin in three cases and sulfamethoxazole/trimethoprim and cefepime, meropenem in two cases, respectively. In conclusion, these findings suggest that physicians taking care of sigmoid colon neobladder patients need to be aware of these high ratios of bacteriuria, pyuria and UTI, including bacteremia.
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use; D012809:Colon, Sigmoid / Q000382:microbiology / Q000601:surgery*; D015653:Cystectomy / Q000009:adverse effects*; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D007958:Leukocyte Count; D064704:Levofloxacin / Q000627:therapeutic use; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D011776:Pyuria / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013420:Sulfamethoxazole / Q000627:therapeutic use; D000078142:Tazobactam; D013845:Thienamycins / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D014547:Urinary Diversion / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D064704:Levofloxacin; D000077723:Cefepime; D010397:Penicillanic Acid; D014295:Trimethoprim; D000077731:Meropenem; D013420:Sulfamethoxazole; D000078142:Tazobactam; D010878:Piperacillin