Postoperative infectious complications in patients undergoing holmium laser enucleation of the prostate: Risk factors and microbiological analysis
Postoperative infectious complications in patients undergoing holmium laser enucleation of the prostate: Risk factors and microbiological analysis
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DOI：
10.1111/iju.13139
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发表时间：
2016-09-01
影响因子：
2.6
通讯作者：
Miwa, Kosei
中科院分区：
文献类型：
--
作者：
Kikuchi, Mina;Kameyama, Koji;Miwa, Kosei
目的 检查术后菌尿和发热并发症的发生率，并调查接受钬激光前列腺剜除术的患者尿液中的细菌菌株。方法我们回顾性分析了 2005 年 9 月至 2014 年 5 月在日本岐阜大学医院接受钬激光前列腺剜除术治疗的 190 名可评估患者。 所有患者均因良性前列腺增生而出现下尿路症状。我们还评估了致病细菌，并将结果与术前尿液培养结果进行了比较。我们分析了术后发热并发症的出现、抗生素预防、患者背景和手术方式之间的关系。结果术前和术后尿培养中细菌分离的频率分别为41%和23%。术前培养最常见的细菌是粪肠球菌，其次是耐甲氧西林表皮葡萄球菌，第三是大肠杆菌。术后，粪肠球菌仍然是最常培养的细菌，其次是大肠杆菌。评估术后菌尿的危险因素。多因素分析显示，术前服用度他雄胺的患者术后菌尿发生率显着低于其他患者。无法确定发热并发症的危险因素。结论钬激光前列腺剜除术围手术期预防性使用抗菌药物可降低术后感染并发症的发生率。手术前给予度他雄胺治疗可能会降低术后菌尿的风险。
ObjectivesTo examine the incidence of postoperative bacteriuria and febrile complications, and to investigate bacterial strains in the urine of patients undergoing holmium laser enucleation of the prostate.MethodsWe retrospectively analyzed 190 evaluable patients treated with holmium laser enucleation of the prostate at the Gifu University Hospital, Gifu, Japan, between September 2005 and May 2014. All patients presented with lower urinary tract symptoms as a result of benign prostatic hyperplasia. We also evaluated the causative bacteria and compared the findings with the results of preoperative urine cultures. We analyzed the relationship between the emergence of postoperative febrile complications, antibiotic prophylaxis, patient background and surgical procedure.ResultsThe frequency of bacterial isolation in preoperative and postoperative urine cultures was 41% and 23%, respectively. Preoperatively, Enterococcus faecalis was the most frequently cultured bacteria, second was methicillin-resistant Staphylococcus epidermidis, and third was Escherichia coli. Postoperatively, Enterococcus faecalis was still the most frequently cultured bacteria, whereas the second was Escherichia coli. Risk factors for postoperative bacteriuria were evaluated. Multivariate analysis showed that the rate of postoperative bacteriuria in patients who had taken dutasteride preoperatively was significantly lower than that in the other patients. Risk factors for febrile complications could not be identified.ConclusionsThe use of perioperative prophylactic antibacterial agents for holmium laser enucleation of the prostate keeps the rate of postoperative infectious complications low. Dutasteride treatment administered before surgery might reduce the risk of postoperative bacteriuria.