Bacteriaemia and bacteriogenic shock in district hospital urological practice

The incidence of bacteriaemia and bacteriogenic shock was studied in 2 series of patients undergoing urological procedures. In the first series (A), 52 of 4333 urological patients had symptoms of bacteriogenic shock. Twenty-five of these had a positive blood culture, giving an incidence of shock with proven bacteriaemia of 0.58%. In the second series (B) 628 patients had blood cultures taken after urological procedures with an incidence of bacteriaemia of 12.7%. Bacteriaemia is most common after prostatic surgery (transurethral prostatectomy 2.7%, retropubic, prostatectomy 37%, prostatic biopsy 20%), and is usually due to Esch. coli, Proteus species and Ps. aeruginosa. In hospital practice these organisms are unlikely to be sensitive to common antibiotics and initial therapy with an aminoglycoside is justified, while awaiting the results of blood culture.