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

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2013, Vol.19 (6), p.1093-1101
• Main Authors: Togo, Yoshikazu, Yamamoto, Shingo, Tanaka, Shiro, Kanematsu, Akihiro, Ogawa, Osamu, Miyazato, Minoru, Saito, Hideo, Arai, Yoichi, Hoshi, Akio, Terachi, Toshiro, Fukui, Katsuya, Kinoshita, Hidefumi, Matsuda, Tadashi, Yamashita, Motoki, Kakehi, Yoshiyuki, Tsuchihashi, Kazunari, Sasaki, Miharu, Ishitoya, Satoshi, Onishi, Hiroyuki, Takahashi, Akira, Ogura, Keiji, Mishina, Mutsuki, Okuno, Hiroshi, Oida, Tomoyuki, Horii, Yasuki, Hamada, Akihiro, Okasyo, Kosuke, Okumura, Kazuhiro, Iwamura, Hiroshi, Nishimura, Kazuo, Manabe, Yumi, Hashimura, Takayuki, Horikoshi, Mikito, Mishima, Takao, Okada, Takuya, Sumiyoshi, Takayuki, Kawakita, Mutsushi, Kanamaru, Sojun, Ito, Noriyuki, Aoki, Dai, Kawaguchi, Risaku, Yamada, Yusuke, Kokura, Koji, Nagai, Jun, Kondoh, Nobuyuki, Kajio, Keisuke, Yoshimoto, Tetsuro
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Antibiotic Prophylaxis; Antimicrobial prophylaxis; Female; Hematology, Oncology and Palliative Medicine; Humans; Incidence; Infectious Diseases; Male; Medical Microbiology; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Original Article; Prospective Studies; Remote infection; Risk Factors; Surgical site infection; Surgical Wound Infection - drug therapy; Surgical Wound Infection - prevention & control; Urinary tract infection; Urinary Tract Infections - drug therapy; Urinary Tract Infections - prevention & control; Urologic Surgical Procedures - adverse effects; Urologic Surgical Procedures - methods; Urological surgery; Virology
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1007/s10156-013-0631-8

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.