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.
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Acknowledgments
The authors express their appreciation to the doctors at the participating institutions who cooperated with this study. We are also grateful for Shiro Tanaka of Kyoto University, who willingly performed the statistical analysis despite the large number of cases. Participating institutions: Hyogo College of Medicine, Kyoto University Graduate School of Medicine, Tohoku University Graduate School of Medicine, Tokai University School of Medicine, Kansai Medical University, Kagawa University School of Medicine, Sizuoka City Hospital, Shiga Medical Center for Adults, Japanese Red Cross Otsu Hospital, National Hospital Organization Kyoto Medical Center, Koseikai Takeda Hospital, Tenri Hospital, Japanese Red Cross Osaka Hospital, Kansai Electric Power Hospital, Noe Hospital, Kobe City Medical General Hospital, Nishi Kobe Medical Center, Chibune general Hospital, Takarazuka Municipal Hospital, Kawanishi City Hospital, Kyowakai Kyoritsu Hospital.
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Togo, Y., Tanaka, S., Kanematsu, A. et al. Antimicrobial prophylaxis to prevent perioperative infection in urological surgery: a multicenter study. J Infect Chemother 19, 1093–1101 (2013). https://doi.org/10.1007/s10156-013-0631-8
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DOI: https://doi.org/10.1007/s10156-013-0631-8