Why the study?
What are the rates and risk factors for surgical site and remote infections following urologic surgery with protocol-based antimicrobial prophylaxis?
What are the rates and risk factors for surgical site and remote infections following urologic surgery with protocol-based antimicrobial prophylaxis?
Protocol-based intravenous antimicrobial prophylaxis in urologic surgery results in varying infection rates depending on contamination levels, with MRSA being a prominent pathogen.
Contamination level drives infection risk after urologic surgery despite protocol prophylaxis; hypothesis-generating for tailored regimens needing randomized confirmation.
Since there are few published reports regarding the impact of urologic surgery on perioperative infections, an epidemiologic analysis was performed on data from 1,156 open or laparoscopic operations in urology collected by the 21 hospitals participating in this study between September 2002 and August 2003. Prophylactic antibiotics were administered intravenously according to our protocol designed on the basis of the invasiveness and contamination levels. The surgical site infection (SSI) rates following clean, clean-contaminated and contaminated surgery were 1.2%. 5.8% and 23.4%, respectively, while the remote infection (RI) rates were 3.5%. 7.1% and 35.9%, respectively. Methicillin-resistant Staphylococcus aureus (MRSA) was most frequently isolated from SSIs as well as RIs, whereas Enterococcus faecalis and Pseudomonas aeruginosa were more frequently discovered in RIs than in SSIs. Several risk factors for SSI and/or RI, such as older age, high ASA score, obesity, diabetes, preoperative chemotherapy, long operation time and much blood loss, were identified by univariate analysis.
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Yamamoto et al. (2005) studied this question.
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