Infected Urine as a Risk Factor for Postprostatectomy Wound Infection

1991 ◽  
Vol 12 (3) ◽  
pp. 147-149 ◽  
Author(s):  
Santiago Richter ◽  
Ruth Lang ◽  
Fruma Zur ◽  
Israel Nissenkorn
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Urinary Catheter ◽  
Urinary Infection ◽  
Wound Infections ◽  
Open Prostatectomy ◽  
Indwelling Catheter ◽  
Indwelling Catheters ◽  
Infected Urine ◽  
Operation Wound

AbstractObjective:To study the relation of preoperative infected urine and postprostatectomy wound infection in patients with and without indwelling bladder catheters.Design:Patients undergoing prostatectomy were evaluated for the presence of infected urine prior to prostatectomy and postoperative wound infection. They were further divided into patients with indwelling urinary catheter and catheter-free patients. All had received antibiotic prophylaxis.Patients: One hundred fifty consecutive patients undergoing open prostatectomy-mean age was 67 years; 100 patients with an indwelling catheter for a mean period of 50 days; 50 catheter-free patients.Results:Wound infection was found in 19 of 81 (23.5%) and in 6 of 69 (8.7%) patients with infected and sterile urine, respectively p = .028). In patients with indwelling catheters prior to operation, wound infection was 22.4% when urine was infected and 8.3% when it was not. In patients without catheters, infected urine was associated with 40% of wound infections, as compared with 8.9% of wound infections in patients with sterile urine. Organisms obtained from infected wound and urine were identical in 84% of cases. These results were obtained despite antibiotic prophylaxis.Conclusions:Wound infection has been demonstrated to be a postprostatectomy complication directly related to the presence of urinary infection at surgery; thus, elective prostatectomy should be deferred until urine becomes sterile.

An Automated Technique for in Vitro Assessment of the Susceptibility of Urinary Catheter Materials to Encrustation

1987 ◽  
Vol 16 (1) ◽  
pp. 37-41 ◽  
Author(s):  
A J Cox ◽  
D W L Hukins ◽  
K E Davies ◽  
J C Irlam ◽  
T M Sutton
Keyword(s):  
Chemical Composition ◽  
Urinary Catheter ◽  
Reaction Vessel ◽  
Indwelling Catheters ◽  
Artificial Urine ◽  
In Vitro Assessment ◽  
Infected Urine ◽  
Automated Technique

An automated technique has been developed for assessing the extent to which existing or potential materials for the construction of indwelling catheters become encrusted during exposure to infected urine. In this technique the enzyme urease is added to artificial urine containing albumin in a reaction vessel which contains the samples to be tested. Controlled replacement of reactants leads to appreciable formation of encrusting deposits which adhere firmly to the surface of the test samples. Deposits have the same chemical composition as those which encrust catheters in vivo.

scholarly journals POST OPERATIVE WOUND INFECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
SUHAIL AMER
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Prophylactic Antibiotics ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Lichtenstein Hernia Repair ◽  
Significant Difference

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad. Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repairelectively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results were assessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections in both groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.

Benign prostatic hyperplasia with PSA > 10.0 ng/ml: Correlations between PSA density and pathological findings of the surgical specimen after open prostatectomy

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 7-10
Author(s):  
V. Scattoni ◽  
L. Ambrosiani ◽  
P. Rovellini ◽  
G. Toia ◽  
S. Bellone ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Infection ◽  
Transrectal Ultrasound ◽  
Prostatic Hyperplasia ◽  
Pathological Findings ◽  
Open Prostatectomy ◽  
Indwelling Catheter ◽  
Surgical Specimen ◽  
Psa Density ◽  
Density Values

— Thirty patients with benign prostatic hyperplasia and PSA levels > 10.0 ng/ml were submitted to open prostatectomy after a precise evaluation with transrectal ultrasound and prostatic biopsies. In the surgical specimen 7 prostatic carcinoma (23%) were found incidentally. In the remaining 23 patients the presence of active histological prostatitis was correlated with the PSA and PSA density values but was not directly due to an asymptomatic urinary infection or indwelling catheter. PIN and other pathological findings were not found to be correlated with PSA values.

Quality Gaps in Documenting Urinary Catheter Use and Infectious Outcomes

2013 ◽  
Vol 34 (8) ◽  
pp. 793-799 ◽  
Author(s):  
Barbara W. Trautner ◽  
Jan E. Patterson ◽  
Nancy J. Petersen ◽  
Sylvia Hysong ◽  
Deborah Horwitz ◽  
...  
Keyword(s):  
Infection Control ◽  
Urinary Catheter ◽  
Tertiary Care ◽  
Urinary Catheters ◽  
Indwelling Catheter ◽  
Term Care ◽  
Indwelling Catheters ◽  
Acute Medicine ◽  
Extended Care ◽  
Bed Days

Objective.To describe the frequency of use of all types of urinary catheters, including but not limited to indwelling catheters, as well as positive cultures associated with the various types. We also determined the accuracy of catheter-days reporting at our institution.Design.Prospective, observational trial based on patient-level review of the electronic medical record. Chart review was compared with standard methods of catheter surveillance and reporting by infection control personnel.Setting.Ten internal medicine and 5 long-term care wards in 2 tertiary care Veterans Affairs hospitals in Texas from July 2010 through June 2011.Participants.The study included 7,866 inpatients.Methods.Measurements included patient bed-days; days of use of indwelling, external, suprapubic, and intermittent urinary catheters; number of urine cultures obtained and culture results; and infection control reports of indwelling catheter-days.Results.We observed 7,866 inpatients with 128,267 bed-days on acute medicine and extended care wards during the study. A urinary catheter was used on 36.9% of the total bed-days observed. Acute medicine wards collected more urine cultures per 1,000 bed-days than did the extended care wards (75.9 and 10.4 cultures per 1,000 bed-days, respectively; P < .0001 ). Catheter-days were divided among indwelling-catheter-days (47.8%), external-catheter-days (48.4%), and other (intermittent- and suprapubic-catheter-days, 3.8%). External catheters contributed to 376 (37.3%) of the 1,009 catheter-associated positive urine cultures. Urinary-catheter-days reported to the infection control department missed 20.1% of the actual days of indwelling catheter use, whereas 12.0% of their reported catheter-days were false.Conclusions.Urinary catheter use was extremely common. External catheters accounted for a large portion of catheter-associated bacteriuria, and standard practices for tracking urinary-catheter-days were unreliable.Trial Registration.ClinicalTrials.gov identifier: NCT01052545.

Caesarean section wound infections and antibiotic use: a retrospective case-series in a tertiary referral hospital in The Gambia

2017 ◽  
Vol 48 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Alex Aulakh ◽  
Patrick Idoko ◽  
Suzanne T Anderson ◽  
Wendy Graham
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Infection Rate ◽  
Wound Infection Rate ◽  
The Gambia ◽  
Referral Hospital ◽  
Wound Infections ◽  
Preoperative Antibiotic Prophylaxis

Ours is the first published study to examine post-Caesarean section (CS) wound infections in The Gambia. We explored risk factors and clinical management retrospectively at a large referral hospital over a 12-month period. A total of 777 cases were identified and records for 682 (88%) were retrieved. The CS rate was 21.8% and the wound infection rate 13.2%. Risk factors included: length of labour; decision-to-incision time and stillbirth. Only 7.4% of women received preoperative antibiotic prophylaxis, but all women received multiple-dose, postoperative antibiotics. The wound infection rate found is likely to be an underestimate owing to loss to follow-up. The adherence to international guidelines regarding preoperative antibiotic prophylaxis needs to be improved.

scholarly journals POST OPERATIVE WOUND INFECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
M. SUHAIL AMER
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Inguinal Hernia Repair ◽  
Prophylactic Antibiotics ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Lichtenstein Hernia Repair

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad.Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repair electively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results wereassessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections inboth groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.

The Chronic Indwelling Catheter and Urinary Infection in Long-Term–Care Facility Residents

2001 ◽  
Vol 22 (5) ◽  
pp. 316-321 ◽  
Author(s):  
Philip W. Smith ◽  
Lindsay E. Nicolle
Keyword(s):  
Antimicrobial Therapy ◽  
Long Term Care ◽  
Urinary Infection ◽  
Indwelling Catheter ◽  
Term Care ◽  
Substantial Impact ◽  
Indwelling Catheters ◽  
The Impact ◽  
Catheter Care

AbstractFrom 5% to 10% of residents of long-term–care facilities have urinary drainage managed with chronic indwelling catheters. These residents are always bacteriuric, usually with a complex microbiological flora of two to five organisms and a biofilm on the catheter that may contribute to obstruction. Residents with chronic indwelling catheters have increased morbidity from urinary infection compared to bacteriuric residents without chronic catheters. The most effective means to prevent infection is limitation of chronic indwelling catheter use. While appropriate catheter care and infection control precautions are recommended in managing these patients, the impact of these practices on the occurrence of urinary infection or prevention of symptomatic episodes has not been evaluated. Symptomatic infection can likely be prevented by attention to catheter care, including early recognition and replacement of obstructed catheters and prevention of catheter trauma. Appropriate use of prophylactic antimicrobial therapy prior to invasive genitourinary procedures is also necessary. Asymptomatic bacteriuria should not be treated. When symptomatic episodes occur, patients should be evaluated clinically and microbiologically and treated with appropriate antimicrobial therapy. Further technological advances in catheter material and urine drainage will be needed to have a substantial impact on the frequency of urinary infection with chronic catheter use.

scholarly journals Wound Infections of Snakebites from the Venomous Protobothrops mucrosquamatus and Viridovipera stejnegeri in Taiwan: Bacteriology, Antibiotic Susceptibility, and Predicting the Need for Antibiotics—A BITE Study

Toxins ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 575 ◽  
Author(s):  
Chih-Chuan Lin ◽  
Yen-Chia Chen ◽  
Zhong Ning Leonard Goh ◽  
Chen-Ken Seak ◽  
Joanna Chen-Yeen Seak ◽  
...  
Keyword(s):  
Wound Infection ◽  
Roc Curve ◽  
Predictive Performance ◽  
Antibiotic Usage ◽  
Emergency Department Visits ◽  
Treatment Modalities ◽  
Wound Infections ◽  
Neutrophil Lymphocyte Ratio ◽  
Cell Counts ◽  
Freeze Dried

Snakebites from Taiwan habus (Protobothrops mucrosquamatus) and green bamboo vipers (Viridovipera stejnegeri) account for two-thirds of all venomous snakebites in Taiwan. While there has been ongoing optimization of antivenin therapy, the proper management of superimposed bacterial wound infections is not well studied. In this Bacteriology of Infections in Taiwanese snake Envenomation (BITE) study, we investigated the prevalence of wound infection, bacteriology, and corresponding antibiotic usage in patients presenting with snakebites from these two snakes. We further developed a BITE score to evaluate the probability of wound infections and guide antibiotic usage in this patient population. All snakebite victims who presented to the emergency departments of seven training and research hospitals and received at least one vial of freeze-dried hemorrhagic antivenin between January 2001 and January 2017 were identified. Patient biodata, laboratory investigation results, and treatment modalities were retrieved. We developed our BITE score via univariate and multiple logistic regression analyses. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performance of the BITE score. Out of 8,295,497 emergency department visits, 726 patients presented with snakebites from a Taiwan habu or a green bamboo viper. The wound infection rate was 22.45%, with seven positive wound cultures, including six polymicrobial infections. Morganella morganii, Enterococcus spp., Bacteroides fragilis, and Aeromonas hydrophila were most frequently cultured. There were no positive blood cultures. A total of 33.0% (n = 106) of snakebite patients who received prophylactic antibiotics nevertheless developed wound infections, while 44.8% (n = 73) of wound infection patients were satisfactorily treated with one of the following antibiotics: amoxicillin/clavulanic acid, oxacillin, cefazolin, and ampicillin/sulbactam. With the addition of gentamicin, the success of antibiotic therapy increased by up to 66.54%. The prognostic factors for the secondary bacterial infection of snakebites were white blood cell counts, the neutrophil lymphocyte ratio, and the need for hospital admission. The area under the ROC curve for the BITE score was 0.839. At the optimal cut-off point of 5, the BITE score had a 79.58% accuracy, 82.31% sensitivity, and 79.71% specificity when predicting infection in snakebite patients. Our BITE score may help with antibiotic stewardship by guiding appropriate antibiotic use in patients presenting with snakebites. It may also be employed in further studies into antibiotic prophylaxis in snakebite patients for the prevention of superimposed bacterial wound infections.

Aspergillus flavus costochondritis following coronary artery bypass grafting: a case report and a brief review of literature

2021 ◽  
pp. 021849232098845
Author(s):  
Aamir Mohammad ◽  
Santhosh Regini Benjamin ◽  
Sameer Mallampati ◽  
Birla Roy Gnanamuthu ◽  
Anne Jennifer Prabhu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Wound Infection ◽  
Artery Bypass ◽  
Correct Diagnosis ◽  
Relevant Literature ◽  
Specific Treatment ◽  
Wound Infections ◽  
Sternal Wound Infection ◽  
Review Of Literature ◽  
Sternal Wound Infections

Bacterial sternal wound infections following cardiac surgery are not uncommon. However, sternal wound infection by a fungus is a rarity, and it warrants a correct diagnosis followed by specific treatment. We report a case of Aspergillus sternal wound infection with costochondritis following cardiac surgery, and briefly review the relevant literature.

Management of Deep Spinal Wound Infections Following Instrumentation Surgery with Subfascial Negative Pressure Wound Therapy

2021 ◽  
Author(s):  
Marcus Rickert ◽  
Michael Rauschmann ◽  
Nizar Latif-Richter ◽  
Mohammad Arabmotlagh ◽  
Tamin Rahim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Wound Infection ◽  
Spinal Fusion ◽  
Negative Pressure Wound Therapy ◽  
Wound Infections ◽  
Wound Therapy ◽  
Postoperative Wound ◽  
Deep Wound ◽  
The Impact

Abstract Background and Study Aims The treatment of infections following a spine surgery continues to be a challenge. Negative pressure wound therapy (NPWT) has been an effective method in the context of infection therapy, and its use has gained popularity in recent decades. This study aims to analyze the impact of known risk factors for postoperative wound infection on the efficiency and length of NPWT therapy until healing. Patients and Methods We analyzed 50 cases of NPWT treatment for deep wound infection after posterior and posteroanterior spinal fusion from March 2010 to July 2014 retrospectively. We included 32 women and 18 men with a mean age of 69 years (range, 36–87 years). Individual risk factors for postoperative infection, such as age, gender, obesity, diabetes, immunosuppression, duration of surgery, intraoperative blood loss, and previous surgeries, as well as type and onset (early vs. late) of the infection were analyzed. We assessed the associations between these risk factors and the number of revisions until wound healing. Results In 42 patients (84%), bacterial pathogens were successfully detected by means of intraoperative swabs and tissue samples during first revision. A total of 19 different pathogens could be identified with a preponderance of Staphylococcus epidermidis (21.4%) and S. aureus (19.0%). Methicillin-resistant S. aureus (MRSA) was recorded in two patients (2.6%). An average of four NPWT revisions was required until the infection was cured. Patients with infections caused by mixed pathogens required a significantly higher number of revisions (5.3 vs. 3.3; p < 0.01) until definitive wound healing. For the risk factors, no significant differences in the number of revisions could be demonstrated when compared with the patients without the respective risk factor. Conclusion NPWT was an effective therapy for the treatment of wound infections after spinal fusion. All patients in the study had their infections successfully cured, and all spinal implants could be retained. The number of revisions was similar to those reported in the published literature. The present study provides insights regarding the effectiveness of NPWT for the treatment of deep wound infection after spinal fusion. Further investigations on the impact of potential risk factors for postoperative wound healing disorders are required. Better knowledge on the impact of specific risk factors will contribute to a higher effectiveness of prophylaxis for postoperative wound infections considering the patient-specific situation.

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