One fifth of patients with neurogenic bladder dysfunction and chronic bacteriuria who undergo major urologic surgery experience infectious complications, researchers found.
J. Quentin Clemens, MD, of the University of Michigan in Ann Arbor, and collaborators studied 77 such patients who underwent 94 major open procedures, including ileocystoplasty, ileal conduit, and pubovaginal sling placement.
Twenty infectious complications developed after 19 (20.2%) of the 94 procedures, according to a report in Urology (2010;75:77-82). The complications included seven febrile urinary tract infections, 12 wound infections, and one episode of sepsis. The rate of multidrug-resistant bacteriuria was 46.3%.
Preoperative urine cultures were available for 77 of the 94 procedures. Twenty-five cultures (32.5%) had multiple unspeciated organisms. Wound infections occurred in 32% of patients with these types of cultures.
“As this culture result is a frequent occurrence in this population, given their chronic bacteriuria and frequent use of antibiotics, it is important to understand how best to manage this result,” the researchers wrote.
In their study, they noted, empiric use of broad-spectrum antibiotics did not decrease the risk of wound infections compared with patients with cultures that were clearly resistant to the perioperative antibiotics.