Use of Antibiotic Prophylaxis for Polymicrobial Urine Culture before Urological Surgery: A Pilot Study

Area of Science:

• Urology
• Infectious Disease
• Clinical Microbiology

Background:

• Preoperative polymicrobial urine cultures are frequently encountered in clinical practice.
• The risk of nosocomial infection associated with these cultures remains poorly understood.
• This study investigates the postoperative infection risk in patients with polymicrobial urine cultures.

Purpose of the Study:

• To analyze the risk of postoperative infection in patients undergoing urological procedures who have preoperative polymicrobial urine cultures.
• To identify factors associated with postoperative infections in this patient cohort.

Main Methods:

• A prospective cohort study was conducted from November 2018 to October 2020.
• Polymicrobial urine cultures were defined as ≥3 bacteria without a leukocyturia threshold on two consecutive samples prior to surgery.
• Postoperative infections were monitored until 30 days post-hospitalization, defined by clinical signs and antibiotic prescription.

Main Results:

• Seven out of sixty-eight patients (10.2%) developed a postoperative infection with a microbe identified in blood or urine.
• A significant association was found between leukocyturia ≥10^4 (p = 0.02) and intraoperative antibiotic prophylaxis (p < 0.001).
• No significant association was observed between postoperative infections and the administration of empirical antibiotic therapy for patients with polymicrobial preoperative urine cultures.

Conclusions:

• The incidence of postoperative infection in patients with preoperative polymicrobial urine cultures undergoing urological procedures is 10.2%.
• Leukocyturia and intraoperative antibiotic prophylaxis are significant factors associated with postoperative infections.
• Further research is required to determine optimal antibiotic prophylaxis strategies for this patient group.