Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture

Daniela María Méndez-Guerrero; Christian Buitrago-Carrascal; Andrés Felipe Puentes-Bernal; Dilma Alexandra Cruz-Arévalo; Diego Camacho-Nieto; Marcelo Andrés Calderón; Juan Camilo Álvarez-Restrepo; Mayra Alejandra Brijaldo-Carvajal; Natalia Perdomo-Bernal; María Carolina Moreno-Matson; Milciades Ibañez-Pinilla; José Daza-Vergara

doi:10.1002/bco2.242

Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture

Título traducido de la contribución: Ver detalles 79 / 5.000 Resultados de traducción Resultado de traducción Profilaxis antibiótica en ureterorrenoscopia flexible con urocultivo negativo

Daniela María Méndez-Guerrero, Christian Buitrago-Carrascal, Andrés Felipe Puentes-Bernal, Dilma Alexandra Cruz-Arévalo, Diego Camacho-Nieto, Marcelo Andrés Calderón, Juan Camilo Álvarez-Restrepo, Mayra Alejandra Brijaldo-Carvajal, Natalia Perdomo-Bernal, María Carolina Moreno-Matson, Milciades Ibañez-Pinilla, José Daza-Vergara

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

Resumen

Objective: To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP).

Methodology: This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20-mm stones and complete information.

Results: Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10-7.37, p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug-resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33-7.59, p = 0.009).

Conclusions: Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60-min preoperative prophylaxis.

Keywords: antibiotics; bacteria; infections; sepsis; urolithiasis.

Título traducido de la contribución	Ver detalles 79 / 5.000 Resultados de traducción Resultado de traducción Profilaxis antibiótica en ureterorrenoscopia flexible con urocultivo negativo
Idioma original	Inglés estadounidense
Páginas (desde-hasta)	688-694
Número de páginas	7
Publicación	BJUI compass
Volumen	4
N.º	6
DOI	https://doi.org/10.1002/bco2.242
Estado	Publicada - nov. 2023
Publicado de forma externa	Sí

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Urología

ODS de las Naciones Unidas

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Méndez-Guerrero, D. M., Buitrago-Carrascal, C., Puentes-Bernal, A. F., Cruz-Arévalo, D. A., Camacho-Nieto, D., Calderón, M. A., Álvarez-Restrepo, J. C., Brijaldo-Carvajal, M. A., Perdomo-Bernal, N., Moreno-Matson, M. C., Ibañez-Pinilla, M., & Daza-Vergara, J. (2023). Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture. BJUI compass, 4(6), 688-694. https://doi.org/10.1002/bco2.242

@article{bcc9677e354f4a07880e946ccca16c0b,

title = "Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture",

abstract = "OBJECTIVE: To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP).METHODOLOGY: This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20-mm stones and complete information.RESULTS: Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10-7.37, p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug-resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33-7.59, p = 0.009). CONCLUSIONS: Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60-min preoperative prophylaxis.",

author = "M{\'e}ndez-Guerrero, {Daniela Mar{\'i}a} and Christian Buitrago-Carrascal and Puentes-Bernal, {Andr{\'e}s Felipe} and Cruz-Ar{\'e}valo, {Dilma Alexandra} and Diego Camacho-Nieto and Calder{\'o}n, {Marcelo Andr{\'e}s} and {\'A}lvarez-Restrepo, {Juan Camilo} and Brijaldo-Carvajal, {Mayra Alejandra} and Natalia Perdomo-Bernal and Moreno-Matson, {Mar{\'i}a Carolina} and Milciades Iba{\~n}ez-Pinilla and Jos{\'e} Daza-Vergara",

note = "{\textcopyright} 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.",

year = "2023",

month = nov,

doi = "10.1002/bco2.242",

language = "English (US)",

volume = "4",

pages = "688--694",

number = "6",

}

Méndez-Guerrero, DM, Buitrago-Carrascal, C, Puentes-Bernal, AF, Cruz-Arévalo, DA, Camacho-Nieto, D, Calderón, MA, Álvarez-Restrepo, JC, Brijaldo-Carvajal, MA, Perdomo-Bernal, N, Moreno-Matson, MC, Ibañez-Pinilla, M & Daza-Vergara, J 2023, 'Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture', BJUI compass, vol. 4, n.º 6, pp. 688-694. https://doi.org/10.1002/bco2.242

TY - JOUR

T1 - Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture

AU - Méndez-Guerrero, Daniela María

AU - Buitrago-Carrascal, Christian

AU - Puentes-Bernal, Andrés Felipe

AU - Cruz-Arévalo, Dilma Alexandra

AU - Camacho-Nieto, Diego

AU - Calderón, Marcelo Andrés

AU - Álvarez-Restrepo, Juan Camilo

AU - Brijaldo-Carvajal, Mayra Alejandra

AU - Perdomo-Bernal, Natalia

AU - Moreno-Matson, María Carolina

AU - Ibañez-Pinilla, Milciades

AU - Daza-Vergara, José

PY - 2023/11

Y1 - 2023/11

N2 - OBJECTIVE: To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP).METHODOLOGY: This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20-mm stones and complete information.RESULTS: Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10-7.37, p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug-resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33-7.59, p = 0.009). CONCLUSIONS: Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60-min preoperative prophylaxis.

AB - OBJECTIVE: To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP).METHODOLOGY: This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20-mm stones and complete information.RESULTS: Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10-7.37, p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug-resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33-7.59, p = 0.009). CONCLUSIONS: Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60-min preoperative prophylaxis.

U2 - 10.1002/bco2.242

DO - 10.1002/bco2.242

M3 - Article

C2 - 37818028

SN - 2688-4526

VL - 4

SP - 688

EP - 694

JO - BJUI compass

JF - BJUI compass

IS - 6

ER -

Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture

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