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Sepsis after elective ureteroscopy.

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Summary
This summary is machine-generated.

Postoperative sepsis occurred in 4.3% of patients after ureteroscopy. Recent urinary tract infection (UTI) treatment significantly increased sepsis risk, highlighting the need for vigilant monitoring and targeted antibiotic selection.

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Area of Science:

  • Urology
  • Infectious Disease
  • Surgical Outcomes

Background:

  • Postoperative sepsis following ureteroscopy is a significant concern.
  • Identifying associated risk factors and understanding current antibiotic practices are crucial for improving patient care.

Purpose of the Study:

  • To determine the incidence of postoperative sepsis after ureteroscopy.
  • To identify factors associated with sepsis development.
  • To analyze common antibiotic practices and culture data in sepsis cases.

Main Methods:

  • Retrospective review of 345 patients undergoing elective ureteroscopy (2010-2015).
  • Collection of data on infection-associated factors, comorbidities (Charlson Age-Adjusted Comorbidity Index, American Society of Anesthesia score).
  • Standardized criteria used to define and identify postoperative sepsis.

Main Results:

  • Sepsis occurred in 4.3% of patients, increasing hospitalization by 5.33 days.
  • Gram-positive and multi-drug resistant (MDR) gram-negative organisms were identified; 46.7% of sepsis cases had negative cultures.
  • Multivariate analysis revealed recent urinary tract infection (UTI) treatment as a significant predictor of sepsis (OR 7.19, p=0.001).

Conclusions:

  • Patients with comorbidities, prior procedures, longer operative times, and recent UTI treatment require close monitoring for sepsis post-ureteroscopy.
  • Perioperative antibiotic selection should target both MDR organisms and gram-positive bacteria in high-risk patients.