Microbiological Studies of Intestinal Bacterial Flora in Urinary Diversion

Summary:

In patients with and without preoperative antibiotic therapy, smear samples from the small and large bowel (terminal ileum, cecum, and ascending colon) were obtained at the time of resection of intestine for Mainz-pouch or ileal conduit urinary diversion. The samples were cultured for isolation and identification of the bacterial flora, and the sensitivity of the isolated bacterial colonies to antibacterial agents was tested.

As compared to the terminal ileum, a greater of bacterial species was isolated in the ascending colon, especially E. coli and anaerobia. In patients who received preoperatively antibiotics, the bacterial flora of the terminal ileum was mostly eliminated. As compared to the wide spectrum of bacterial species in untreated patients, the bacterial flora of the ascending colon was markedly reduced after antibiotic therapy, but complete sterilization of the intestine was not achieved.

Concerning the sensitivity of isolated bacterial colonies für the tested antimicrobials, either administration of ampicillin/sulbactam or the more cost-effective combination of ampicillin and metronidazole is an appropriate first-line therapy for preoperatively suppressing intestinal bacterial flora and perioperative prophylaxis.

Key words:

Urinary diversion - Intestinal bacterial flora - colon - Ileum