Antimicrobial prophylaxis to prevent perioperative infection in urological surgery: a multicenter study.

Abstract

We prospectively investigated the rates of incidence of surgical site infection (SSI), urinary tract infection (UTI), and remote infection (RI) in 4,677 patients who underwent urological surgery from January to December 2010, including 2,507 endourological cases, 1,276 clean cases, 807 clean-contaminated cases, and 87 contaminated cases involving bowel segments. A single dose of antimicrobial prophylaxis (AMP) was administered in the endourological, clean, and clean-contaminated surgery cases, except for patients who underwent transurethral resection of the prostate (TURP) or percutaneous nephrolithotripsy (PNL). AMP was administered within 72 h in TURP and PNL, and AMP was administered within 48 h in contaminated surgery cases. In cases of endourological surgery, UTI was observed in 4% and RI in 0%, and SSI, UTI, and RI were seen in 1%, 1%, and 1%, respectively, of clean surgery cases, in 3%, 3%, and 2%, respectively, of clean-contaminated surgery cases, and in 17%, 30%, and 10%, respectively, of contaminated surgery cases. In multivariate analysis of the risk factors for infection, operative time was a significant risk factor for UTI in endourological surgery, and American Society of Anesthesiologists score and operative time were significant risk factors for RI in clean surgery. No significant risk factor was found in analyses of clean-contaminated and contaminated surgery cases. A single-dose AMP regimen was shown to be effective and feasible for prevention of perioperative infection in urological surgery.

• Authors: Yoshikazu Togo, Shiro Tanaka, Akihiro Kanematsu, Osamu Ogawa, Minoru Miyazato, Hideo Saito, Yoichi Arai, Akio Hoshi, Toshiro Terachi, Katsuya Fukui, Hidefumi Kinoshita, Tadashi Matsuda, Motoki Yamashita, Yoshiyuki Kakehi, Kazunari Tsuchihashi, Miharu Sasaki, Satoshi Ishitoya, Hiroyuki Onishi, Akira Takahashi, Keiji Ogura, Mutsuki Mishina, Hiroshi Okuno, Tomoyuki Oida, Yasuki Horii, Akihiro Hamada, Kosuke Okasyo, Kazuhiro Okumura, Hiroshi Iwamura, Kazuo Nishimura, Yumi Manabe, Takayuki Hashimura, Mikito Horikoshi, Takao Mishima, Takuya Okada, Takayuki Sumiyoshi, Mutsushi Kawakita, Sojun Kanamaru, Noriyuki Ito, Dai Aoki, Risaku Kawaguchi, Yusuke Yamada, Koji Kokura, Jun Nagai, Nobuyuki Kondoh, Keisuke Kajio, Tetsuro Yoshimoto, Shingo Yamamoto
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 19 Issue 6 Pg. 1093-101 (Dec 2013) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 23818257 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (administration & dosage)
• Antibiotic Prophylaxis
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Multivariate Analysis
• Prospective Studies
• Risk Factors
• Surgical Wound Infection (drug therapy, prevention & control)
• Urinary Tract Infections (drug therapy, prevention & control)
• Urologic Surgical Procedures (adverse effects, methods)