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The risk factors of urinary tract infection after transurethral resection of bladder tumors

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Abstract

Purpose

Few studies mention the necessity of antimicrobial prophylaxis (AMP) for transurethral resection of bladder tumor (TURBT) and the risk factors for postoperative urinary tract infections (UTIs) after TURBT. To evaluate the necessity of AMP and to detect the risk of UTIs, we examined the perioperative clinical factors.

Methods

687 patients who underwent TURBT between 2006 and 2017 at Hiroshima Prefectural Hospital were examined retrospectively. We defined the postoperative UTIs as febrile UTIs (≥ 38 °C). The AMP for the TURBT that we used was mostly cephalosporin generation 1. The association between the perioperative clinical/pathological factors and postoperative UTIs was assessed by logistic regression retrospectively.

Results

21 patients (3.1%) suffered from postoperative UTIs, and almost all of them were successfully treated with the immediate administration of antibiotics. Univariate analysis showed that past pelvic radiotherapy (p = 0.024, odds ratio (OR) 6.00), tumor size (≥ 2cm) (p = 0.008, OR 3.38), age (≥ 75 years) (p = 0.036, OR 2.65), preoperative hospital stay (≥ 5 days) (p = 0.017, OR 3.76), asymptomatic pyuria (p = 0.038, OR 2.54) and bacteriuria (p = 0.044, OR 2.97) were all associated with postoperative UTIs.

Conclusions

We demonstrated that AMP was effective for patients who underwent TURBT, and history of pelvic radiotherapy, high age, preoperative hospital stay and a certain tumor size were the risk factors as well as pyuria and bacteriuria of postoperative UTIs.

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Abbreviations

TURBT:

Transurethral resection of bladder tumors

AMP:

Antimicrobial prophylaxis

UTIs:

Urinary tract infections

References

  1. Goldwasser B, Bogokowsky B, Nativ O et al (1983) Urinary infections following transurethral resection of bladder tumors: rate and source. J Urol 129:1123–1124

    Article  CAS  Google Scholar 

  2. Appell RA, Flynn JT, Paris AM, Blandy JP (1980) Occult bacterial colonization of bladder tumors. J Urol 124:345–346

    Article  CAS  Google Scholar 

  3. Kanamaru S, Terai A, Ishitoya S et al (2004) Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: a preliminary study. Int J Urol 11:355–363

    Article  Google Scholar 

  4. MacDermott JP, Ewing RE, Somerville JF, Gray BK (1988) Cephradine prophylaxis in transurethral procedures for carcinoma of the bladder. Br J Urol 62:136–139

    Article  CAS  Google Scholar 

  5. Gasser TC, Wisard M, Frei R (1996) Oral fleroxacin prophylaxis in transurethral surgery. J Urol 156:146–148

    Article  CAS  Google Scholar 

  6. di Silverio ZF, Ferrone G, Carati I (1990) Prophylactic chemotherapy with fosfomycin trometamol during transurethral surgery and urological manoeuvres: results of a multicentre study. Infection 18:98–102

    Article  Google Scholar 

  7. Amin M (1992) Antibacterial prophylaxis in urology: a review. Am J Med 92:114–117

    Article  Google Scholar 

  8. Alsaywid BS, Smith GH (2013) Antibiotic prophylaxis for transurethral urological surgeries: systematic review. Urol Ann 5:61–74

    Article  Google Scholar 

  9. Janknegt RA (1992) Prophylaxis in urological surgery. Infection 20:217–224

    Article  Google Scholar 

  10. Upton JD, Das S (1986) Prophylactic antibiotics in transurethral resection of bladder tumors: are they necessary? Urology 27:421–423

    Article  CAS  Google Scholar 

  11. Delavierre D, Huiban B, Fournier G et al (1993) The value of antibiotic prophylaxis in transurethral resection of bladder tumors: apropos of 61 cases. Prog Urol 3:577–582

    CAS  PubMed  Google Scholar 

  12. Badenoch DF, Murdoch DA, Tiptaft RC (1990) Microbiological study of bladder tumors, their histology and infective complications. Urology 35:5–8

    Article  CAS  Google Scholar 

  13. Yokoyama M, Fujii Y, Yoshida S et al (2009) Discarding antimicrobial prophylaxis for transurethral resection of bladder tumor: a feasibility study. Int J Urol 16:61–63

    Article  Google Scholar 

  14. Wolf JS Jr, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ (2008) Urologic surgery antimicrobial prophylaxis best practice policy panel: best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol 179:1379–1390

    Article  Google Scholar 

  15. Yamamoto S, Shigemura K, Kiyota H et al (2016) Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition. Int J Urol 23:814–824

    Article  Google Scholar 

  16. Grabe M, Bjerklund-Johansen TE, Botto H et al (2013) Guidelines on urological infections. https://uroweb.org/wp-content/uploads/18_Urological-infections_LR.pdf. Accessed 25 Mar 2019

  17. Wagenlehner FM, Wagenlehner C, Schinzel S, Naber KG (2005) Prospective, randomized, multicentric, open, comparative study on the efficacy of a prophylactic single dose of 500 mg levofloxacin versus 1920 mg trimethoprim/sulfamethoxazole versus a control group in patients undergoing TUR of the prostate. Eur Urol 47:549–556

    Article  CAS  Google Scholar 

  18. Qiang W, Jianchen W, MacDonald R, Monga M, Wilt TJ (2005) Antibiotic prophylaxis for transurethral prostatic resection in men with preoperative urine containing less than 100,000 bacteria per ml: a systematic review. J Urol 173:1175–1181

    Article  Google Scholar 

  19. Prasad KN, Pradhan S, Datta NR (1995) Urinary tract infection in patients of gynecological malignancies undergoing external pelvic radiotherapy. Gynecol Oncol 57:380–382

    Article  CAS  Google Scholar 

  20. Roberts FJ, Murphy J, Ludgate C (1990) The value and significance of routine urine cultures in patients referred for radiation therapy of prostatic malignancy. Clin Oncol 2:18–21

    Article  CAS  Google Scholar 

  21. Bialas I, Bessell EM, Sokal M, Slack R (1989) A prospective study of urinary tract infection during pelvic radiotherapy. Radiother Oncol 16:305–309

    Article  CAS  Google Scholar 

  22. Bessell EM, Granville-White M (1994) The effect of prophylactic trimethoprim on aerobic urinary tract infection during pelvic radiotherapy and the incidence of infections due to fastidious or anaerobic organisms. Clin Oncol 6:116–120

    Article  CAS  Google Scholar 

  23. Çetinel B (2015) Chemotherapy and pelvic radiotherapy-induced bladder injury. Urologia 82:2–5

    Article  Google Scholar 

  24. Matulewicz RS, Sharma V, McGuire BB et al (2015) The effect of surgical duration of transurethral resection of bladder tumors on postoperative complications: an analysis of ACS NSQIP data. Urol Oncol 33:19–24

    Article  Google Scholar 

  25. Tsujinaka T, Yamamoto K, Fujita J et al (2013) Subcuticular sutures versus staples for skin closure after open gastrointestinal surgery: a phase 3, multicentre, open-label, randomised controlled trial. Lancet 382:1105–1112

    Article  Google Scholar 

  26. Pereira HO, Rezende EM, Couto BR (2015) Length of preoperative hospital stay: a risk factor for reducing surgical infection in femoral fracture cases. Rev Bras Ortop 50:638–646

    Article  Google Scholar 

  27. Hamasuna R, Betsunoh H, Sueyoshi T et al (2004) Bacteria of preoperative urinary tract infections contaminate the surgical fields and develop surgical site infections in urological operations. Int J Urol 11:941–947

    Article  Google Scholar 

  28. Yamamoto H, Omote K, Sonoda H, Namiki A (2002) A case of sepsis that developed during transurethral resection of the prostate. J Anesth 16:242–244

    Article  Google Scholar 

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Authors and Affiliations

Authors

Contributions

YK: protocol/project development, data management, data analysis, and manuscript writing. AG: manuscript editing. KY: data collection. SO: manuscript editing. MK: protocol/project development.

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Correspondence to Yuki Kohada.

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The authors declare that they have no conflict of interest.

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Kohada, Y., Goriki, A., Yukihiro, K. et al. The risk factors of urinary tract infection after transurethral resection of bladder tumors. World J Urol 37, 2715–2719 (2019). https://doi.org/10.1007/s00345-019-02737-3

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  • DOI: https://doi.org/10.1007/s00345-019-02737-3

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