1
|
Etani T, Wachino C, Sakata T, Aoki M, Gonda M, Shimizu N, Nagai T, Unno R, Taguchi K, Naiki T, Hamamoto S, Okada A, Kawai N, Nakamura A, Yasui T. Using fosfomycin to prevent infection following ureterorenoscopy in response to shortage of cephalosporins: a retrospective preliminary study. BMC Urol 2024; 24:145. [PMID: 38997692 PMCID: PMC11241913 DOI: 10.1186/s12894-024-01530-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND In 2019, the shortage of cefazolin led to the demand for cefotiam and cefmetazole exceeding the supply. The Department of Nephro-urology at Nagoya City University Hospital used fosfomycin as a substitute for perioperative prophylaxis. This retrospective preliminary study evaluated the efficacy of fosfomycin and cefotiam for preventing infections following ureterorenoscopy. METHODS The study included 182 patients who underwent ureterorenoscopy between January 2018 and March 2021). Perioperative antibacterial treatment with fosfomycin (n = 108) or cefotiam (n = 74) was administered. We performed propensity score matching in both groups for age, sex, preoperative urinary catheter use, and preoperative antibiotic treatment. RESULTS The fosfomycin and cefotiam groups (n = 69 per group) exhibited no significant differences in terms of patients' median age, operative duration, preoperative urine white blood cell count, preoperative urine bacterial count, and the rate of preoperative antibiotic treatment. In the fosfomycin and cefotiam groups, the median duration of postoperative hospital stay was 3 and 4 days, respectively; the median maximum postoperative temperature was 37.3 °C and 37.2 °C, respectively. The fosfomycin group had lower postoperative C-reactive protein levels and white blood cell count than the cefotiam group. However, the frequency of fever > 38 °C requiring additional antibiotic administration was similar. CONCLUSIONS During cefotiam shortage, fosfomycin administration enabled surgeons to continue performing ureterorenoscopies without increasing the complication rate.
Collapse
Affiliation(s)
- Toshiki Etani
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan.
| | - Chiharu Wachino
- Division of Infection Prevention & Control, Nagoya City University Hospital, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Takuya Sakata
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Maria Aoki
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Masakazu Gonda
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Nobuhiko Shimizu
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Takashi Nagai
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Rei Unno
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Kazumi Taguchi
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Taku Naiki
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Shuzo Hamamoto
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Atsushi Okada
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Noriyasu Kawai
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Atsushi Nakamura
- Division of Infection Prevention & Control, Nagoya City University Hospital, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Takahiro Yasui
- Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| |
Collapse
|
2
|
dos Santos LL, Fraga IDA, de Almeida VA, Santos AHR, Almeida IM, Nascimento TR, Porto BC, Passerotti CC, Artifon ELDA, Otoch JP, da Cruz JAS. Antibiotics prophylaxis at the time of catheter removal after radical prostatectomy: a systematic review of the literature and meta-analysis. Acta Cir Bras 2024; 39:e390424. [PMID: 38324800 PMCID: PMC10854371 DOI: 10.1590/acb390424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/16/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To conduct a systematic literature review with meta-analysis to identify whether antibiotic prophylaxis after removal of the indwelling urinary catheter reduces posterior infections. METHODS A systematic literature review was conducted in the databases PubMed, Embase, Cochrane, Google Scholar, and Latin American and Caribbean Health Sciences Literature, using the keywords "antibiotics" AND "prostatectomy" AND "urinary catheter." RESULTS Three articles were identified having the scope of our review, with 1,040 patients, which were subjected to our meta-analysis revealing a marginally significant decrease in the risk of urinary infection after indwelling urinary catheter removal (odds ratio-OR = 0.51; 95% confidence interval-95%CI 0.27-0.98; p = 0.04; I2 = 0%). No difference was found regarding the presence of bacteriuria (OR = 0.39; 95%CI 0.12-1.24; p = 0.11; I2 = 73%). CONCLUSIONS In our meta-analysis, there was a significant decrease in urinary tract infection with antibiotic prophylaxis after indwelling urinary catheter removal following radical prostatectomy.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Breno Cordeiro Porto
- Universidade de São Paulo – School of Medicine – Surgical Technique and Experimental Surgery – São Paulo (SP) – Brazil
| | - Carlo Camargo Passerotti
- Universidade de São Paulo – School of Medicine – Surgical Technique and Experimental Surgery – São Paulo (SP) – Brazil
- Hospital Alemão Oswaldo Cruz – Specialized Center for Urology – São Paulo (SP) – Brazil
| | | | - Jose Pinhata Otoch
- Universidade de São Paulo – School of Medicine – Surgical Technique and Experimental Surgery – São Paulo (SP) – Brazil
| | - José Arnaldo Shiomi da Cruz
- Universidade Nove de Julho – São Paulo (SP) – Brazil
- Universidade de São Paulo – School of Medicine – Surgical Technique and Experimental Surgery – São Paulo (SP) – Brazil
- Hospital Alemão Oswaldo Cruz – Specialized Center for Urology – São Paulo (SP) – Brazil
| |
Collapse
|
3
|
Okugi H, Nakamura T, Okazaki H, Yoshihara T. [RISK FACTORS FOR INFECTIONS AT SURGICAL SITES AND REMOTE REGIONS IN PATIENTS UNDERGOING LAPAROSCOPIC PYELOPLASTY AND EVALUATION OF ANTIMICROBIAL PROPHYLAXIS]. Nihon Hinyokika Gakkai Zasshi 2022; 113:128-133. [PMID: 37866932 DOI: 10.5980/jpnjurol.113.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
(Objectives) We measured the incidences of surgical site infections (SSIs) and remote infections (RIs) in patients undergoing laparoscopic pyeloplasty to treat ureteropelvic junction obstruction, and the effects of prophylactic antimicrobial agents. (Patients and Methods) We compared the incidences of SSI and RI, risk factors for such infections, and differences in the prophylactic antimicrobial protocols in 94 patients who underwent laparoscopic pyeloplasty at our hospital from August 2009 to June 2021. (Results) Two patients experienced SSIs (2.1%) and three had RIs (3.2%). There were no significant differences in the incidence of either infection type in those who complied and did not comply with the prophylactic antimicrobial guidelines. (Conclusions) Laparoscopic pyeloplasty is associated with low incidences of both SSI and RI; prophylactic antimicrobials may not be required. A large multicenter survey is required for continuous evaluation of SSIs and RIs and to accumulate data.
Collapse
Affiliation(s)
- Hironobu Okugi
- Department of Urology, Tatebayashi Kosei General Hospital
| | | | | | | |
Collapse
|
4
|
Banakhar M, Yamani A. In Patients with Neurogenic Detrusor Overactivity and Hinman's Syndrome: Would Intravesical Botox Injections Decrease the Incidence of Symptomatic Urinary Tract Infections. Res Rep Urol 2021; 13:659-663. [PMID: 34513743 PMCID: PMC8421780 DOI: 10.2147/rru.s317361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To study the effect of intravesical Botox injection on the incidence of recurrent symptomatic UTI in neurogenic bladder patients with detrusor overactivity. Patients and Methods This was a prospective cohort study for patients who received Botox intravesical injection. We included patients with neurogenic bladder with detrusor overactivity and symptomatic recurrent UTI. We compared the number of symptomatic UTIs at six months pre- and post-intravesical Botox injection. Patient files were reviewed for diagnosis, vesico-uretric reflux, hydronephrosis, urodynamic findings pre- and post-injection, and dose of Botox used. Patients were followed for the number of symptomatic UTIs post-Botox injection. Results There were 93 patients diagnosed with neurogenic detrusor overactivity and symptomatic recurrent UTI. Patients were categorized into three categories: Group 1 – adults, Group 2 – pediatrics, Group 3 – non-neurogenic neurogenic bladder (Hinman’s syndrome). Spina bifida was diagnosed in 22 adults (Group 1) and 32 pediatric patients (Group 2). After receiving Botox injection, 75% of all patients (70) had a significant decrease in number of symptomatic UTIs. Urodynamic tests post-injection showed an improvement in bladder capacity, compliance, and detrusor pressure versus baseline in all three groups. Correlation analysis showed significant correlation between decreased symptomatic UTI post-Botox injection and detrusor pressure post-injection as well as bladder compliance; p-value=0.01 and p=0.021, respectively. Conclusion Intravesical Botox injection may decrease incidence of symptomatic UTI in neurogenic detrusor overactivity. This effect seemed to be related to better bladder management.
Collapse
Affiliation(s)
- Mai Banakhar
- Urology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Yamani
- Urology Department, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
5
|
Maruyama R, Fukushima H, Fukuda S, Yasuda Y, Uehara S, Tanaka H, Kijima T, Yoshida S, Yokoyama M, Matsuoka Y, Saito K, Kihara K, Fujii Y. Nonuse of antimicrobial prophylaxis in clean surgeries for adrenal and renal tumors: Results of the risk-based strategy in 1362 consecutive patients. Int J Urol 2021; 28:1032-1038. [PMID: 34247430 DOI: 10.1111/iju.14642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the incidence of perioperative infections without antimicrobial prophylaxis in patients undergoing clean surgeries for adrenal and renal tumors. METHODS We prospectively enrolled 1362 consecutive patients who underwent minimally invasive adrenalectomy (n = 303), radical nephrectomy (n = 499), and partial nephrectomy (n = 560) using the gasless laparoendoscopic single-port surgery technique between 2005 and 2019. In 1059 patients, antimicrobial prophylaxis was not administered. The remaining 303 patients were considered at high risk for infection and received single-dose antimicrobial prophylaxis. The endpoint was the incidence of perioperative infections within 1 month from the surgery date. Perioperative infections were classified into surgical site infections, urinary tract infections, and remote infections. RESULTS Seventy-four patients whose collecting systems were opened during partial nephrectomy were excluded, and the remaining 1013 patients with nonuse of antimicrobial prophylaxis and 275 patients with single-dose antimicrobial prophylaxis were retrospectively analyzed. The incidence of superficial surgical site infections, deep/organ-space surgical site infections, urinary tract infections, and remote infections was 1.6%, 0.7%, 2.8%, and 1.3%, respectively, in patients with nonuse of antimicrobial prophylaxis and 0.4%, 1.8%, 1.5%, and 1.5%, respectively, in patients with single-dose antimicrobial prophylaxis. All patients who developed perioperative infections were successfully treated. No clinical or surgical variables were significantly associated with the incidence of surgical site infections. One limitation of the present study was its nonrandomized and noncontrolled design. CONCLUSIONS In minimally invasive clean surgeries for adrenal and renal tumors, antimicrobial prophylaxis is not necessary when individual risk of infection is considered low.
Collapse
Affiliation(s)
- Riko Maruyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Fukushima
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Yasuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sho Uehara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshiki Kijima
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazutaka Saito
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunori Kihara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
6
|
Togo Y, Fukui K, Ueda Y, Kanamaru S, Shimizu Y, Wada K, Sadahira T, Yamada Y, Matsumoto M, Hamasuna R, Ishikawa K, Takai M, Maekawa Y, Yasuda M, Kokura K, Kondoh N, Takiuchi H, Yamamoto S. Comparison of single‐ and multiple‐dose cefazolin as prophylaxis for transurethral enucleation of prostate: A multicenter, prospective, randomized controlled trial by the Japanese Research Group for Urinary Tract Infection. Int J Urol 2020; 27:244-248. [DOI: 10.1111/iju.14181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Yoshikazu Togo
- Department of Urology Hyogo College of Medicine NishinomiyaHyogoJapan
| | - Koji Fukui
- Department of Urology Takarazuka City Hospital TakarazukaHyogoJapan
| | - Yasuo Ueda
- Department of Urology Nishinomiya Municipal Central Hospital NishinomiyaHyogoJapan
| | - Sojun Kanamaru
- Department of Urology Kobe City Nishi‐Kobe Medical Center Kobe HyogoJapan
| | - Yosuke Shimizu
- Department of Urology Kobe City Nishi‐Kobe Medical Center Kobe HyogoJapan
| | - Koichiro Wada
- Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama OkayamaJapan
| | - Takuya Sadahira
- Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama OkayamaJapan
| | - Yusuke Yamada
- Department of Urology Hyogo College of Medicine NishinomiyaHyogoJapan
| | - Masahiro Matsumoto
- Department of Urology University of Occupational and Environmental Health Japan KitakyushuFukuokaJapan
| | - Ryoichi Hamasuna
- Department of Urology Federation of National Public Services Affiliated Personal Mutual Aid Associations Shin‐Kokura Hospital Kitakyushu FukuokaJapan
| | - Kiyohito Ishikawa
- Department of Urology Fujita Health University School of Medicine Toyoake AichiJapan
| | - Manabu Takai
- Department of Urology Kizawa Memorial Hospital MinokamoGifuJapan
| | - Yuka Maekawa
- Department of Urology Gifu University Hospital GifuGifuJapan
| | - Mitsuru Yasuda
- Center for Nutrition Support and Infection Control Gifu University Hospital Gifu GifuJapan
| | - Koji Kokura
- Department of Urology Takarazuka City Hospital TakarazukaHyogoJapan
| | - Nobuyuki Kondoh
- Department of Urology Kyowakai Kyoritsu Hospital Kawanishi Hyogo Japan
| | - Hidekazu Takiuchi
- Department of Urology Nishinomiya Municipal Central Hospital NishinomiyaHyogoJapan
| | - Shingo Yamamoto
- Department of Urology Hyogo College of Medicine NishinomiyaHyogoJapan
| |
Collapse
|
7
|
Shigemura K, Yamamichi F, Nishimoto K, Kitagawa K, Fujisawa M. Protocol for a comparison study of 1-day (single dose) versus 2-day prophylactic antibiotic administration in Holmium Laser enucleation of the prostate (HoLEP): a randomized controlled trial. F1000Res 2019; 8:161. [PMID: 31143442 PMCID: PMC6524744 DOI: 10.12688/f1000research.17660.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2019] [Indexed: 11/24/2022] Open
Abstract
Background: The best method of antimicrobial prophylaxis administration for surgical site infection (SSI) in transurethral holmium laser resection and enucleation of the prostate (HoLEP)/bipolar transurethral enucleation (TUEB) remains controversial. The purpose of this study is to compare one-day and two-day cefazolin in a randomized 2 nd-phase study to help establish a protocol with a 95% confidence interval (CI) for SSI prevention. Methods: Patients undergoing HoLEP/TUEB for benign prostate hyperplasia without preoperative pyuria will be enrolled and randomized to receive prophylactic antibiotic administration for HoLEP/TUEB in two groups, 1-day (single dose) cefazolin and 2-day cefazolin. The primary endpoint is the occurrence rate of postoperative urinary tract infection or urogenital infection within 30 days after HoLEP/TUEB with a statistical 95% CI in comparison between those groups. Secondary outcomes include the kind of infectious disease and evidence of diagnosis, day of diagnosis of infectious disease, performance of urine or blood culture, detection of bacteria, treatments, duration of treatments, AEs other than surgical site infection, and drug-induced AEs. Discussion: The results of this study will provide evidence for defining the optimal duration of cefazolin prophylactic antibiotic administration for SSI. Trial registration: This study was registered in the University Hospital Medical Information Network-Clinical Trial Registry ( UMIN000027955) based on recommendations from the International Committee of Medical Journal Editors (ICMJE) on July 1 st 2017.
Collapse
Affiliation(s)
- Katsumi Shigemura
- Department of Urology, Kobe University, Kobe, Hyogo, 650-0017, Japan
- Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan
| | | | - Kento Nishimoto
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan
| | - Koichi Kitagawa
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University, Kobe, Hyogo, 650-0017, Japan
| |
Collapse
|
8
|
Shigemura K, Yamamichi F, Nishimoto K, Kitagawa K, Fujisawa M. Protocol for a comparison study of 1-day versus 2-day prophylactic antibiotic administration in Holmium Laser enucleation of the prostate (HoLEP): a randomized controlled trial. F1000Res 2019; 8:161. [PMID: 31143442 PMCID: PMC6524744 DOI: 10.12688/f1000research.17660.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 10/12/2023] Open
Abstract
Background: The best method of antimicrobial prophylaxis administration for surgical site infection (SSI) in transurethral holmium laser resection and enucleation of the prostate (HoLEP)/bipolar transurethral enucleation (TUEB) remains controversial. The purpose of this study is to compare one-day and two-day cefazolin in a randomized 2 nd-phase study to help establish a protocol with a 95% confidence interval (CI) for SSI prevention. Methods: Patients undergoing HoLEP/TUEB for benign prostate hyperplasia without preoperative pyuria will be enrolled and randomized to receive prophylactic antibiotic administration for HoLEP/TUEB in two groups, 1-day cefazolin and 2-day cefazolin. The primary endpoint is the occurrence rate of postoperative urinary tract infection or urogenital infection within 30 days after HoLEP/TUEB with a statistical 95% CI in comparison between those groups. Secondary outcomes include the kind of infectious disease and evidence of diagnosis, day of diagnosis of infectious disease, performance of urine or blood culture, detection of bacteria, treatments, duration of treatments, AEs other than surgical site infection, and drug-induced AEs. Discussion: The results of this study will provide evidence for defining the optimal duration of cefazolin prophylactic antibiotic administration for SSI. Trial registration: This study was registered in the University Hospital Medical Information Network-Clinical Trial Registry ( UMIN000027955) based on recommendations from the International Committee of Medical Journal Editors (ICMJE) on July 1 st 2017.
Collapse
Affiliation(s)
- Katsumi Shigemura
- Department of Urology, Kobe University, Kobe, Hyogo, 650-0017, Japan
- Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan
| | | | - Kento Nishimoto
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan
| | - Koichi Kitagawa
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University, Kobe, Hyogo, 650-0017, Japan
| |
Collapse
|
9
|
Li JK, Teoh JY, Ng CF. Updates in endourological management of urolithiasis. Int J Urol 2018; 26:172-183. [PMID: 30575154 DOI: 10.1111/iju.13885] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/21/2018] [Indexed: 12/23/2022]
Abstract
Urinary stone disease, or urolithiasis, is a very common disease with increasing prevalence and incidence. With the advancement of endoscopic techniques, the treatment outcomes of ureteroscopy (or transureteral lithotripsy) and percutaneous nephrolithotomy are continuously improving. In recent years, there have been many new developments in the field, including new endoscopy design, more effective auxiliary tools, improvement in treatment protocols, introduction of robotic technology, combining both ureteroscopy and percutaneous nephrolithotomy (endoscopic combined intrarenal surgery or transureteral lithotripsy-assisted percutaneous nephrolithotomy), improvement in laser technology, and so on. All these new inputs will further improve the treatment efficacy and safety of the procedures, thus benefiting our patients. In the present review, we briefly go through the main steps of ureteroscopy and percutaneous nephrolithotomy, with a concise description and application of these new advances.
Collapse
Affiliation(s)
- Joseph Km Li
- S. H. Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jeremy Yc Teoh
- S. H. Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Fai Ng
- S. H. Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
10
|
Comparison of guideline recommendations for antimicrobial prophylaxis in urologic procedures: variability, lack of consensus, and contradictions. Int Urol Nephrol 2018; 50:1923-1937. [DOI: 10.1007/s11255-018-1971-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/18/2018] [Indexed: 10/28/2022]
|
11
|
Paradella AC, Musegante AFDA, Brites C. Comparison of different antibiotic protocols for asymptomatic bacteriuria in patients with neurogenic bladder treated with botulinum toxin A. Braz J Infect Dis 2016; 20:623-626. [PMID: 27765580 PMCID: PMC9427594 DOI: 10.1016/j.bjid.2016.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/15/2016] [Accepted: 08/02/2016] [Indexed: 11/29/2022] Open
Abstract
Intravesical botulinum toxin A (BoNTA) injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI) was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days) for the treatment of asymptomatic bacteriuria. All patients were performing self or assisted clean intermittent bladder catheterization and underwent a rigid cystoscopy, under general or regional anesthesia with sedation, and the drug used was Botox®. A total of 616 procedures were performed during the study period. There were 11 identified cases of UTI (1.8%) with a trend to a higher rate in the group that used antibiotics for longer time. This report shows that a single dose of antibiotics before the detrusor BoNTA injection is enough to prevent UTI. Randomized clinical trial should be conducted for definitive conclusions.
Collapse
Affiliation(s)
| | | | - Carlos Brites
- Complexo Hospitalar Universitário Professor Edgard Santos, Salvador, BA, Brazil.
| |
Collapse
|
12
|
Yamamoto S, Shigemura K, Kiyota H, Wada K, Hayami H, Yasuda M, Takahashi S, Ishikawa K, Hamasuna R, Arakawa S, Matsumoto T. Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition. Int J Urol 2016; 23:814-824. [DOI: 10.1111/iju.13161] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Shingo Yamamoto
- Department of Urology; Hyogo College of Medicine; Nishinomiya Hyogo Japan
| | - Katsumi Shigemura
- Department of Urology; Kobe University Graduate School of Medicine; Kobe Hyogo Japan
| | | | - Koichiro Wada
- Department of Urology; Okayama University Hospital; Okayama Kagawa Japan
| | - Hiroshi Hayami
- Department of Urology; Graduate School of Medical and Dental Sciences; Kagoshima University; Kagoshima Japan
| | - Mitsuru Yasuda
- Department of Urology; Graduate School of Medicine; Gifu University; Gifu Japan
| | - Satoshi Takahashi
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Kiyohito Ishikawa
- Department of Urology; Fujita Health University School of Medicine; Toyoake Aichi Japan
| | - Ryoichi Hamasuna
- Department of Urology; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Soichi Arakawa
- Department of Urology; Kobe University Graduate School of Medicine; Kobe Hyogo Japan
| | - Tetsuro Matsumoto
- Department of Urology; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | | |
Collapse
|
13
|
Ellett J, Prasad MM, Purves JT, Stec AA. Post-surgical infections and perioperative antibiotics usage in pediatric genitourinary procedures. J Pediatr Urol 2015; 11:358.e1-6. [PMID: 26271822 DOI: 10.1016/j.jpurol.2015.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/06/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Post-surgical infections (PSIs) are a source of preventable perioperative morbidity. No guidelines exist for the use of perioperative antibiotics in pediatric urologic procedures. OBJECTIVE This study reports the rate of PSIs in non-endoscopic pediatric genitourinary procedures at our institution. Secondary aims evaluate the association of PSI with other perioperative variables, including wound class (WC) and perioperative antibiotic administration. STUDY DESIGN Data from consecutive non-endoscopic pediatric urologic procedures performed between August 2011 and April 2014 were examined retrospectively. The primary outcome was the rate of PSIs. PSIs were classified as superficial skin (SS) and deep/organ site (D/OS) according to Centers for Disease Control and Prevention guidelines, and urinary tract infection (UTI). PSIs were further stratified by WC1 and WC2 and perioperative antibiotic usage. A relative risk and chi-square analysis compared PSI rates between WC1 and WC2 procedures. RESULTS A total of 1185 unique patients with 1384 surgical sites were reviewed; 1192 surgical sites had follow-up for inclusion into the study. Ten total PSIs were identified, for an overall infection rate of 0.83%. Of these, six were SS, one was D/OS, and three were UTIs. The PSI rate for WC1 (885 sites) and WC2 (307 sites) procedures was 0.34% and 2.28%, respectively, p < 0.01. Relative risk of infection in WC2 procedures was 6.7 (CI 1.75-25.85, p = 0.0055). The rate of infections in WC1 procedures was similar between those receiving and not receiving perioperative antibiotics (0.35% vs. 0.33%). All WC2 procedures received antibiotics. DISCUSSION Post-surgical infections are associated with significant perioperative morbidity. In some studies, PSI can double hospital costs, and contribute to hospital length of stay, admission to intensive care units, and impact patient mortality. Our study demonstrates that the rate of PSI in WC1 operations is low, irrespective of whether the patient received perioperative antibiotics (0.35%) or no antibiotics (0.33%). WC2 operations were the larger source of morbidity with an infection rate of 2.28% and a 6.7 fold higher increase in relative risk. CONCLUSIONS WC1 procedures have a rate of infection around 0.3%, which is independent of the use of perioperative antibiotics. WC2 procedures have a higher rate of infection, with a relative risk of 6.7 for the development of PSI, and should be the target of guidelines for periprocedural prophylaxis.
Collapse
Affiliation(s)
- Justin Ellett
- Medical University of South Carolina, Department of Urology, Charleston, SC, USA
| | - Michaella M Prasad
- Medical University of South Carolina, Department of Urology, Charleston, SC, USA
| | - J Todd Purves
- Medical University of South Carolina, Department of Urology, Charleston, SC, USA
| | - Andrew A Stec
- Medical University of South Carolina, Department of Urology, Charleston, SC, USA.
| |
Collapse
|