Comparison of three different antibiotic protocols in transurethral resection of bladder tumour and the possible infectious risk factors: A non-randomized, prospective study

Panach-Navarrete, Jorge; Valls-González, Lorena; Sánchez-Cano, E.; Medina-González, María; Castelló-Porcar, Ana; Martínez-Jabaloyas, José María

doi:10.5489/cuaj.5207

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…In 2018, Navarette published a study in which he investigated 216 patients who underwent TUR-BT and followed 3 different antibiotic prophylaxis protocols, similar to the groups in the present study, with the difference being that in the third group antibiotic therapy was continued at home for 5 days after discharge. The study concluded that the patients who received single-dose antibiotic prophylaxis before TUR-BT had a higher risk of rehospitalization for fever in comparison to those who received prolonged antibiotic therapya fact that was also confirmed by the present study [34]. Moreover, according to the above study, tumour necrosis, the number of tumours and a longer hospital stay might predispose the patients to develop infectious complicationsa finding that was not proved by the present study.…”

Section: Resultssupporting

confidence: 63%

Antibiotic Prophylaxis in Transurethral Resections: What Are the Criteria That Should Be Followed?

Pricop¹

2020

FARMACIA

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Antibiotic prophylaxis for urinary tract infections (UTIs) after endourology procedures is a controversial subject. Our objectives are the evaluation of postoperative incidence of bacteriuria and infectious complications after endoscopic surgery, to create a profile for who needs prolonged antibiotic therapy, and to analyse the risk factors that lead to the appearance of postoperative UTIs. We carried out a non-randomized, prospective study. Patients who underwent transurethral resection of bladder tumour (TUR-BT) or transurethral resection of prostate (TUR-P) and had a negative preoperative urine culture were included. Out of 705 subjects TUR-P 13.4%, respectively TUR-BT 7.2% had positive cultures. The encountered bacteria were E. coli, Klebsiella, Enterococcus, and others with MAR index ranging from 0.18 to 0.75 (Pseudomonas). The study suggests that prolonging antibiotics at home is not useful in patients who have undergone TUR-P, but it might decrease the risk of TUR-BT patients. Keeping the urinary catheter for a prolonged time increases the risk of UTIs. Rezumat Profilaxia antibiotică pentru infecțiile urinare (ITU) după proceduri endoscopice rămâne un subiect controversat. Obiectivele noastre au fost evaluarea incidenței postoperatorii ale bacteriuriei și complicațiilor infecțioase dupa intervenții endoscopice, de a crea un profil pentru pacientul care necesită antibioterapie prelungită și pentru a analiza factorii de risc care conduc la apariția infecțiilor urinare. Am desfășurat un studiu nerandomizat, prospectiv. Pacienții care au beneficiat de rezecția transuretrală a vezicii urinare (TUR-V) și rezecția transuretrală a prostatei (TUR-P) cu uroculturi negative preoperatorii au fost introduși în studiu. Din 705 pacienți 13,4% TUR-P, respectiv 7,2% TUR-V au avut culturi pozitive. Bacteriile întâlnite au fost E. coli, Klebsiella, Enterococus și altele cu un index MAR între 0,18 și 0,75 (Pseudomonas). Studiul sugerează că prelungirea antibioterapiei la domiciliu nu este utilă pentru pacienții TUR-P, dar poate reduce riscul ITU pentru pacienții TUR-V. Menținerea cateterului un timp prelungit crește riscul de ITU.

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Section: Resultssupporting

confidence: 63%

Antibiotic Prophylaxis in Transurethral Resections: What Are the Criteria That Should Be Followed?

Pricop¹

2020

FARMACIA

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“…Nevertheless, despite the current evidence, tumor necrosis is not yet an independent predisposing factor to infection. (12) Limitations to our study included the fact that patients with a pre-procedure PUC were…”

Section: Discussionmentioning

confidence: 99%

“…(10) There is still no consensus on the use of antibiotic pro-phylaxis regarding TURBT, despite the fact that it is a frequent procedure. (12) The aim of the present study was to analyze the microbiology and incidence of drug resistance in patients that underwent TURBT and to identify independent risk factors for postoperative UTI.…”

Section: Introductionmentioning

confidence: 99%

Urinary tract infections after transurethral resection of bladder tumor: Microbiology, antibiotic resistance and associated risk factors.

Martínez-Delgado

Garza-Gangemi

Castillejos-Molina

2020

rmu

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Objective: Investigate the microbiology and incidence of drug resistance in patients undergoing TURBT and to identify independent risk factors for UTI following surgery. Material & Methods : Retrospective observational study of prospectively collected data of 199 patients who underwent TURBT in a tertiary care center in Mexico City between 2017-2019. Baseline characteristics and microbiological data (frequency of isolated bacteria and antibiotic resistance pattern) were analyzed according to the presence of UTI following surgery. Binary logistic regression analysis was performed to identify independent risk factors for UTI. Results: A preoperative positive urine culture (PUC) was present in 28 patients (14%), the most common isolated pathogens were Escherichia coli(48%), Enterococcus faecalis(24%) and Proteus mirabilis(7%). UTI was documented in 20 patients after TURBT (10%), being E. coli(45%) the most common uropathogen which was resistant to Trimethoprim/Sulfamethoxazole(60%) and Ciprofloxacin(40%). Other common isolated pathogens were E. faecalis(27%) and P. mirabilis(9%). There was significant difference in the presence of a PUC before TURBT and necrosis (p=0.001). On the multivariate analysis the PUC before TURBT was associated with UTI after TURBT (OR7.04 [95%CI 2.11-23.29]). Limitations: Retrospective study with information limited to the clinical file. Originality: There is little information about UTI after TURBT in global literature, in Mexico there is no information, being this study unique in his kind. Conclusions: The incidence of UTI after TURBT was 10%. The strongest associated risk factor for UTI after TURBT was a preoperative PUC. The most common isolated uropathogen was E. coli. Trimethoprim/Sulfamethoxazole(60%) and Ciprofloxacin(40%) were the most resistant antibiotics for E. coli.

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Comparison of three different antibiotic protocols in transurethral resection of bladder tumour and the possible infectious risk factors: A non-randomized, prospective study

Cited by 2 publications

References 19 publications

Antibiotic Prophylaxis in Transurethral Resections: What Are the Criteria That Should Be Followed?

Antibiotic Prophylaxis in Transurethral Resections: What Are the Criteria That Should Be Followed?

Urinary tract infections after transurethral resection of bladder tumor: Microbiology, antibiotic resistance and associated risk factors.

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