MICROBIOLOGICAL STUDIES OF INTESTINAL BACTERIAL-FLORA IN URINARY-DIVERSION

In patients with and without preoperative antibiotic therapy, smear sa mples from the small and large bower (terminal ileum, cecum, and ascen ding colon) were obtained at the time of resection of intestine for Ma inz-pouch or ileal conduit urinary diversion. The samples were culture d for isolation and identification of the bacterial flora, and the sen sitivity of the isolated bacterial colonies to antibacterial agents wa s tested. As compared to the terminal ileum, a greater of bacterial sp ecies was isolated in the ascending colon, especially E. coli and anae robia. In patients who received preoperatively antibiotics, the bacter ial flora of the terminal ileum was mostly eliminated. As compared to the wide spectrum of bacterial species in untreated patients, the bact erial flora of the ascending colon was markedly reduced after antibiot ic therapy, but complete sterilization of the intestine was not achiev ed. Concerning the sensitivity of isolated bacterial colonies fur the tested antimicrobials, either administration of ampicillin/sulbactam o r the more cost-effective combination of ampicillin and metronidazole is an appropriate first-line therapy for preoperatively suppressing in testinal bacterial flora and perioperative prophylaxis.