Charton M, Vallancien G, Veillon B, Prapotnich D, Mombet A, Brisset J M
Department of Urology, Porte de Choisy Medicosurgical Center, Paris, France.
Eur Urol. 1990;17(2):134-8. doi: 10.1159/000464021.
The first 400 patients treated on an inpatient basis at our center underwent bacteriological follow-up after extracorporeal lithotripsy (ECL) for ureteric or renal stones. 278 patients did not have any urinary tract infection on the urine culture before ECL. They did not receive any antibiotic prophylaxis and 4.8% of the patients developed infectious problems, with significant bacteriuria in only 1.5% of the cases. 89 patients had urinary tract infection on the preoperative cultures. 21.3% developed either fever or significant bacteriuria and this virtually always occurred in patients who were treated for less than 4 days before ECL, with septicemia in 4.5% of the cases. 33 patients with sterile urine received flush antibiotic prophylaxis and none of them developed postoperative infection. Two of these patients had infection at the time of the flush: one of them, who, by error, did not receive antibiotic treatment prior to ECL, developed bacteremia after the procedure. The rational use of antibiotics in conjunction with ECL should ensure effective prevention of urinary tract infections without requiring the excessive use of antibiotics.
我们中心首批400例接受住院治疗的患者在接受输尿管或肾结石体外冲击波碎石术（ECL）后接受了细菌学随访。278例患者在ECL前的尿培养中没有任何尿路感染。他们未接受任何抗生素预防措施，4.8%的患者出现感染问题，仅1.5%的病例有显著菌尿。89例患者术前培养有尿路感染。21.3%的患者出现发热或显著菌尿，且几乎总是发生在ECL前治疗少于4天的患者中，4.5%的病例发生败血症。33例无菌尿患者接受了预防性冲洗抗生素治疗，无一例发生术后感染。其中两名患者在冲洗时已有感染：其中一名患者因失误在ECL前未接受抗生素治疗，术后发生菌血症。合理使用抗生素结合ECL应能有效预防尿路感染，而无需过度使用抗生素。
