[Bacterial nosocomial infections in urology: nosocomial urinary tract infections].

The range and extent of infections acquired in hospitals depend firstly on the organisms occurring in the hospital concerned, secondly on the incidence of transmission, depending on the standard of hygiene in the hospital and, finally, on the resistance of the patient. In the past decades changes have taken place in the sphere of all three factors with a resultant unfavourable increase in nosocomial infections. Reasons for this development are found in the widespread, massive and often irrational administration of antibacterial chemotherapeutic agents (leading to selective resistance of hospital bacteria), in neglect of the rules of asepsis and antisepsis and also in an increased disposition of patients towards hospital infections. About 50% of all nosocomial infections affect the urinary tract and 70% of these cases are caused by catheterization of the bladder. Special attention must be paid to correct technique in placing the catheter and in deviating the urine (closed drainage systems). The incidence of nosocomial urinary tract infections and the species of organisms involved have been favourably influenced by a new antibiotic regimen, as well as improved hygienic measures in the Urological Department of the Allgemeine Poliklinik der Stadt Wien (reduction in the mean postoperative infection rate following adenomectomy from 90 to 40%; decrease in typical hospital organisms such as Pseudomonas aeruginosa from over 50 to below 10% and in indole-positive Proteus strains from 25 to below 5%).