Ibrahim A I
Department of Surgery, College of Medicine, King Saud University, Abba, Saudi Arabia.
East Afr Med J. 1996 Feb;73(2):107-10.
One hundred and one consecutive prostatic patients with sterile urines were prospectively studied for the risk factors involved in the hospital acquired pre-prostatectomy bacteriuric and its implications. Eleven out of 101 patients (11%) became bacteriuric at operation whereas ninety of 101 patients (89%) remained abacteriuric. Nine of the eleven bacteriuric patients (82%) had pre-operative indwelling urethral catheters compared to 37/90 (41%) abacteriurics (P < 0.05). Mean catheter duration was 22.22 and 9.92 days respectively (P < 0.05). Three out of eleven (27%) bacteriuric patients had chronic retention of urine compared to one of ninety (1%) abacteriuric patients. Past history of acute retention, vesical stones, vesical diverticulae, diabetes mellitus and azotaemia were not significant risk factors. Post-operative fever did not correlate with positive blood cultures. However, eight of the eleven (73%) bacteriurics developed bacteraemia compared to only one out of ninety (1%) abacteriuric patients. It is concluded that the significant risk factors which would be strong indications for antimicrobial prophylaxis in prostatectomy are chronic retention of urine and prolonged pre-operative indwelling urethral catheterization for more than ten days. Azotaemia, diabetes mellitus and associated bladder pathologies were not significant and therefore do not warrant antimicrobial prophylaxis.
对101例连续的前列腺患者进行前瞻性研究，这些患者尿液无菌，研究其与医院获得性前列腺切除术前菌尿相关的危险因素及其影响。101例患者中有11例（11%）在手术时发生菌尿，而101例患者中有90例（89%）仍无菌尿。11例菌尿患者中有9例（82%）术前留置导尿管，而90例无菌尿患者中有37例（41%）留置导尿管（P<0.05）。平均导尿管留置时间分别为22.22天和9.92天（P<0.05）。11例菌尿患者中有3例（27%）有慢性尿潴留，而90例无菌尿患者中有1例（1%）有慢性尿潴留。急性尿潴留、膀胱结石、膀胱憩室、糖尿病和氮质血症的既往史不是显著的危险因素。术后发热与血培养阳性无关。然而，11例菌尿患者中有8例（73%）发生菌血症，而90例无菌尿患者中只有1例（1%）发生菌血症。结论是，在前列腺切除术中作为抗菌预防有力指征的显著危险因素是慢性尿潴留和术前留置导尿管超过10天。氮质血症、糖尿病和相关的膀胱病变不显著，因此不需要抗菌预防。
