Bacteriuria After Diagnostic Flexible Cystoscopy Without Antibiotic Prophylaxis: A Prospective Study

Area of Science:

• Urology
• Infectious Disease
• Medical Device Reprocessing

Background:

• Flexible cystoscopy is a common procedure for diagnosing lower urinary tract conditions in women.
• Effective reprocessing of cystoscopes is crucial to prevent healthcare-associated infections.
• High-level disinfection (HLD) is a standard for reprocessing semi-critical medical devices like cystoscopes.

Purpose of the Study:

• To evaluate the incidence of bacteriuria following flexible cystoscopy.
• To assess the efficacy of ortho-phthalaldehyde (OPA) for high-level disinfection of flexible cystoscopes.
• To determine the safety of flexible cystoscopy in women when using OPA-based HLD.

Main Methods:

• A prospective study included 78 women undergoing outpatient flexible cystoscopy.
• Exclusion criteria included existing urinary tract infections or bleeding disorders.
• Urine cultures were obtained before and immediately after cystoscopy; cystoscopes were reprocessed using ortho-phthalaldehyde.

Main Results:

• One woman (1.3%) developed post-cystoscopy bacteriuria.
• The mean age of participants was 58.7 years.
• The most common indication for cystoscopy was hematuria (58.4%).

Conclusions:

• The incidence of bacteriuria after flexible cystoscopy using OPA HLD is low (1.3%).
• Ortho-phthalaldehyde is an effective agent for HLD of flexible cystoscopes.
• Maintaining rigorous reprocessing protocols (rinsing, drying, exposure tracking) is essential for HLD efficacy.