Surgical hand hygiene and febrile urinary tract infections in endourological surgery: a single-centre prospective cohort study

Abstract

Surgical hand hygiene reduces the risk of surgical site infections (SSIs). SSIs are not considered an issue in endourological surgery, whereas febrile urinary tract infections (f-UTIs) and urological sepsis are becoming problematic. We wondered whether surgical hand hygiene is necessary for endourological surgery. Therefore, we aimed to evaluate the influence of surgical hand hygiene on f-UTI onset in endourological surgery by comparing procedures in which surgical hand hygiene with double gloving was used with those in which regular hand hygiene with double gloving was used between April 2016 and July 2020. In this prospective cohort study of 477 patients who underwent endourological surgeries, surgeons in the surgical hand hygiene and regular hygiene groups performed surgery on 259 and 218 patients, respectively. There was no significant difference in patient background, and multivariate analyses revealed no significant differences in f-UTI onset (odds ratio, 0.87; p = 0.74) between the two groups. In conclusion, regular hand hygiene with double gloving may be considered an alternative to surgical hand hygiene to prevent endourological f-UTIs, which could alter operational protocols for endourological surgery. Further studies are needed to validate our findings.

Analysis of pathogen distribution and associated risk factors for surgical site infections following laparoscopic urological surgeries

“…These interventions inherently carry a higher risk of introducing pathogens directly into the urinary system. The introduction of pathogens into the urinary system can lead to urinary tract infections (UTIs), which, if not properly managed, may ascend to the kidneys, causing pyelonephritis 12 . This can result in bacteremia or sepsis, especially in patients with compromised immune systems or comorbidities 13 .…”

“…The introduction of pathogens into the urinary system can lead to urinary tract infections (UTIs), which, if not properly managed, may ascend to the kidneys, causing pyelonephritis. 12 This can result in bacteremia or sepsis, especially in patients with compromised immune systems or comorbidities. 13 The progression from a localized surgical site infection to systemic involvement underscores the critical need for early identification and management of SSIs in urological surgeries.…”