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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2021; 30(03): e157-e164
DOI: 10.1055/s-0041-1730320
Original Article | Artículo Original
General urology / Urología General

Effect of Antibiotic Prophylaxis on Infectious Complications in Patients with Asymptomatic Bacteriuria Undergoing Urologic Surgery

Efecto de la profilaxis antibiótica sobre las complicaciones infecciosas en pacientes con bacteriuria asintomática programados a cirugía urológica
Jorge A. Ramos-Castaneda 
1   Public Health Observatory, Graduate School, Universidad CES, Medellín, Antioquia, Colombia
,
Alberto Ruano-Ravina 
2   Department of Preventive Medicine and Public Health, Universidad de Santiago de Compostela, Santiago de Compostela, Galicia, España
3   Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Madrid, España
,
Javier Osorio-Manrique
4   Department of Urology, Centro Especializado de Urología, Neiva, Huila, Colombia
,
Jackeline Barreto-Mora
5   Departamento de Infectología, Grupo de Investigación Infecto-Control, Hospital Universitario Hernando Moncaleno Perdomo, Neiva, Huila, Colombia
,
Angela María Segura-Cardona 
1   Public Health Observatory, Graduate School, Universidad CES, Medellín, Antioquia, Colombia
,
Elkin V. Lemos-Luengas 
1   Public Health Observatory, Graduate School, Universidad CES, Medellín, Antioquia, Colombia
› Institutsangaben Funding Statement The principal author is beneficiary of the grant 677-2014 COLCIENCIAS and Departamento del Huila.
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Abstract

Objectives To identify the effect of duration of surgical antibiotic prophylaxis (SAP) and other variables on infectious postsurgical complications in patients with asymptomatic bacteriuria (ASB) undergoing urological surgery.

Methods We conducted an observational study of a cohort of patients with ASB scheduled for urologic surgery at three health service providers in Colombia. The study population comprised all patients with planned urologic surgery who had ASB prior to surgery from April 2018 to January 2019. The intervention evaluated was the duration of preoperative SAP, and the outcome variable was the development of any postoperative infectious complications for up to 30 days after the procedure.

Results The present study included 184 patients with ASB scheduled for urologic surgery.

The median duration of preoperative SAP (p = 0.49) or of 1 dose SAP (risk ratio [RR] = 1.24; 95% confidence interval [CI]: 0.45–3.39) were not statistically different in patients with postsurgical infectious complications. Infectious complications were more frequent among patients with benign prostatic hyperplasia (RR = 6.57; 95%CI: 1.98–21.76) and hospitalization in the preceding 3 months (RR = 8.32; 95%CI: 2.69–25.71).

Conclusion One dose of antimicrobial therapy is sufficient to avoid infectious complications in patients with ASB. There were other factors associated with postsurgical infectious complications, such as benign prostatic hyperplasia and hospitalization in the preceding 3 months.

Resumen

Objetivos Identificar el efecto de la duración de la profilaxis antibiótica quirúrgica (PAQ) y otras variables sobre las complicaciones infecciosas posquirúrgicas en pacientes con bacteriuria asintomática (BA) sometidos a cirugía urológica.

Métodos Se realizó un estudio observacional de una cohorte de pacientes con BA programados para cirugía urológica en tres instituciones de salud en Colombia. La población de estudio comprendió a todos los pacientes programados para cirugía urológica y con BA en el periodo de Abril del 2018 a Enero 2019. La intervención evaluada fue la duración de la PAQ preoperatoria, y la variable de resultado fue el desarrollo de cualquier complicación infecciosa posoperatoria hasta 30 días después del procedimiento.

Resultados El estudio incluyó a 184 pacientes con BA programados para cirugía urológica. La mediana de duración de la PAQ preoperatoria (p = 0,49) o 1 dosis de PAQ (razón de riesgo [RR]: 1,24; intervalo de confianza [IC] del 95%: 0,45 a 3,39) no fueron estadísticamente diferentes en pacientes con complicaciones infecciosas posquirúrgicas. Las complicaciones infecciosas fueron más frecuentes entre los pacientes con hiperplasia prostática benigna (RR: 6,57; IC del 95%: 1,98 a 21,76) y hospitalización en los 3 meses anteriores (RR: 8,32; IC del 95%: 2,69 a 25,71).

Conclusión Una dosis de terapia antimicrobiana es suficiente para evitar complicaciones infecciosas en pacientes con BA. Hubo otros factores asociados con complicaciones infecciosas posquirúrgicas, como hiperplasia prostática benigna y hospitalización en los tres meses anteriores.

Keywords

asymptomatic bacteriuria - urinary tract infection - bacteremia - sepsis - surgical wound infection - urologic surgical procedures - urologic surgery

Palabras clave

bacteriuria asintomática - infección del tracto urinario - bacteriemia - sepsis - infección de la herida quirúrgica - procedimientos quirúrgicos urológicos - cirugía urológica


Publikationsverlauf

Eingereicht: 19. August 2020

Angenommen: 21. Januar 2021

Artikel online veröffentlicht:
30. September 2021

© 2021. Sociedad Colombiana de Urología. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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