HOSPITAL-ACQUIRED PRE-PROSTATECTOMY BACTERIURA - RISK-FACTORS AND IMPLICATIONS

One hundred and one consecutive prostatic patients with sterile urines were prospectively studied for the risk factors involved in the hospi tal acquired pre-prostatectomy bacteriuric and its implications. Eleve n out of 101 patients (11%) became bacteriuric at operation whereas ni nety of 101 patients (89%) remained abacteriuric. Nine of the eleven b acteriuric patients (82%) had pre-operative indwelling urethral cathet ers compared to 37/90 (41%) abacteriurics (P<0.05). Mean catheter dura tion was 22.22 and 9.92 days respectively (P<0.05). Three out of eleve n (27%) bacteriuric patients had chronic retention of urine compared t o one of ninety (1%) abacteriuric patients. Past history of acute rete ntion, vesical stones, vesical diverticulae, diabetes mellitus and azo taemia were not significant risk factors, Post-operative fever did not correlate with positive blood cultures. However, eight of the eleven (73%) bacteriurics developed bacteraemia compared to only one out of n inety (1%) abacteriuric patients. It is concluded that the significant risk factors which would be strong indications for antimicrobial prop hylaxis in prostatectomy are chronic retention of urine and prolonged pre-operative indwelling urethral catheterization for more than ten da ys. Azotaemia, diabetes mellitus and associated bladder pathologies we re not significant and therefore do not warrant antimicrobial prophyla xis.