EVALUATION OF ENDOTOXIURIA FOR DIAGNOSIS OF URINARY-TRACT INFECTION AFTER MAJOR SURGICAL-PROCEDURES

In 148 patients after major surgical procedures urinary endotoxin leve ls were determined and compared with bacteriological results. The stud y was designed as a screening study. Urine samples were collected once by suprapubic or transurethral catheters. In a first series of 49 pat ients urine bacteriology was positive (mainly, Gram-negative rods were found) in 3 cases. However endotoxin determination was positive in th ese 3 patients and in a further 10 patients receiving antibiotic thera py for other reasons. Therefore, the following 99 patients were studie d also by urinalysis by reagent strips for leukocytes and nitrite. In the second series, 12 urine cultures positive for bacteria were observ ed. Eleven samples were also endotoxin positive. Five more patients we re endotoxin positive and had pathological but unspecific reagent stri p results. These patients were treated with antibiotics for other reas ons. Patients with candida found in the urine culture (n=5) were endot oxin negative. Thus, endotoxin determination in urine obtained by supr apubic or transurethral catheters proved to be a very sensitive method for diagnosis of bacterial contamination, even during antibiotic trea tment.