Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture
Abstract Objective To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared wi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.242 |
| _version_ | 1797663540070318080 |
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| author | Daniela María Méndez‐Guerrero Christian Buitrago‐Carrascal Andrés Felipe Puentes‐Bernal Dilma Alexandra Cruz‐Arévalo Diego Camacho ‐Nieto Marcelo Andrés Calderón Juan Camilo Álvarez‐Restrepo Mayra Alejandra Brijaldo‐Carvajal Natalia Perdomo‐Bernal María Carolina Moreno‐Matson Milciades Ibañez‐Pinilla José Daza‐Vergara |
| author_facet | Daniela María Méndez‐Guerrero Christian Buitrago‐Carrascal Andrés Felipe Puentes‐Bernal Dilma Alexandra Cruz‐Arévalo Diego Camacho ‐Nieto Marcelo Andrés Calderón Juan Camilo Álvarez‐Restrepo Mayra Alejandra Brijaldo‐Carvajal Natalia Perdomo‐Bernal María Carolina Moreno‐Matson Milciades Ibañez‐Pinilla José Daza‐Vergara |
| author_sort | Daniela María Méndez‐Guerrero |
| collection | DOAJ |
| description | Abstract Objective To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP). Methodology This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20‐mm stones and complete information. Results Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10–7.37, p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug‐resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33–7.59, p = 0.009). Conclusions Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60‐min preoperative prophylaxis. |
| first_indexed | 2024-03-11T19:17:07Z |
| format | Article |
| id | doaj.art-6df83379243f4928bfb59f9ee33b551a |
| institution | Directory Open Access Journal |
| issn | 2688-4526 |
| language | English |
| last_indexed | 2024-03-11T19:17:07Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj.art-6df83379243f4928bfb59f9ee33b551a2023-10-09T01:20:53ZengWileyBJUI Compass2688-45262023-11-014668869410.1002/bco2.242Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine cultureDaniela María Méndez‐Guerrero0Christian Buitrago‐Carrascal1Andrés Felipe Puentes‐Bernal2Dilma Alexandra Cruz‐Arévalo3Diego Camacho ‐Nieto4Marcelo Andrés Calderón5Juan Camilo Álvarez‐Restrepo6Mayra Alejandra Brijaldo‐Carvajal7Natalia Perdomo‐Bernal8María Carolina Moreno‐Matson9Milciades Ibañez‐Pinilla10José Daza‐Vergara11Universidad del Rosario Bogotá ColombiaDepartment of Urology Hospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaDepartment of Urology Hospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaDepartment of Urology Hospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaDepartment of Urology Hospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaUniversidad del Rosario Bogotá ColombiaUniversidad Nacional de Colombia Bogotá ColombiaHospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaHospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaHospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaUniversidad del Rosario Bogotá ColombiaHospital Universitario Mayor Méderi ‐ Universidad del Rosario Bogotá ColombiaAbstract Objective To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP). Methodology This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20‐mm stones and complete information. Results Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10–7.37, p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug‐resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33–7.59, p = 0.009). Conclusions Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60‐min preoperative prophylaxis.https://doi.org/10.1002/bco2.242antibioticsbacteriainfectionssepsisurolithiasis |
| spellingShingle | Daniela María Méndez‐Guerrero Christian Buitrago‐Carrascal Andrés Felipe Puentes‐Bernal Dilma Alexandra Cruz‐Arévalo Diego Camacho ‐Nieto Marcelo Andrés Calderón Juan Camilo Álvarez‐Restrepo Mayra Alejandra Brijaldo‐Carvajal Natalia Perdomo‐Bernal María Carolina Moreno‐Matson Milciades Ibañez‐Pinilla José Daza‐Vergara Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture BJUI Compass antibiotics bacteria infections sepsis urolithiasis |
| title | Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture |
| title_full | Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture |
| title_fullStr | Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture |
| title_full_unstemmed | Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture |
| title_short | Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture |
| title_sort | antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture |
| topic | antibiotics bacteria infections sepsis urolithiasis |
| url | https://doi.org/10.1002/bco2.242 |
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