Antimicrobial prophylaxis to prevent perioperative infection in urological surgery: a multicenter study

被引：15

作者：

Togo, Yoshikazu ^{[1
]}

Tanaka, Shiro ^{[2
]}

Kanematsu, Akihiro ^{[3
]}

Ogawa, Osamu ^{[3
]}

Miyazato, Minoru ^{[4
]}

Saito, Hideo ^{[4
]}

Arai, Yoichi ^{[4
]}

Hoshi, Akio ^{[5
]}

Terachi, Toshiro ^{[5
]}

Fukui, Katsuya ^{[6
]}

Kinoshita, Hidefumi ^{[6
]}

Matsuda, Tadashi ^{[6
]}

Yamashita, Motoki ^{[7
]}

Kakehi, Yoshiyuki ^{[7
]}

Tsuchihashi, Kazunari ^{[8
]}

Sasaki, Miharu ^{[8
]}

Ishitoya, Satoshi ^{[9
]}

Onishi, Hiroyuki ^{[9
]}

Takahashi, Akira ^{[10
]}

Ogura, Keiji ^{[10
]}

Mishina, Mutsuki ^{[11
]}

Okuno, Hiroshi ^{[11
]}

Oida, Tomoyuki ^{[12
]}

Horii, Yasuki ^{[12
]}

Hamada, Akihiro ^{[13
]}

Okasyo, Kosuke ^{[13
]}

Okumura, Kazuhiro ^{[13
]}

Iwamura, Hiroshi ^{[14
]}

Nishimura, Kazuo ^{[14
]}

Manabe, Yumi ^{[15
]}

Hashimura, Takayuki ^{[15
]}

Horikoshi, Mikito ^{[16
]}

Mishima, Takao ^{[16
]}

Okada, Takuya ^{[16
]}

Sumiyoshi, Takayuki ^{[17
]}

Kawakita, Mutsushi ^{[17
]}

Kanamaru, Sojun ^{[18
]}

Ito, Noriyuki ^{[18
]}

Aoki, Dai ^{[19
]}

Kawaguchi, Risaku ^{[19
]}

Yamada, Yusuke ^{[20
]}

Kokura, Koji ^{[20
]}

Nagai, Jun ^{[21
]}

Kondoh, Nobuyuki ^{[21
]}

Kajio, Keisuke ^{[22
]}

Yoshimoto, Tetsuro ^{[22
]}

Yamamoto, Shingo ^{[1
]}

机构：

[1] Hyogo Coll Med, Dept Urol, Nishinomiya, Hyogo 6638501, Japan

[2] Kyoto Univ, Dept Pharmacoepidemiol, Grad Sch Med & Publ Hlth, Kyoto, Japan

[3] Kyoto Univ, Grad Sch Med, Dept Urol, Kyoto, Japan

[4] Tohoku Univ, Grad Sch Med, Dept Urol, Sendai, Miyagi 980, Japan

[5] Tokai Univ, Sch Med, Dept Urol, Tokyo 151, Japan

[6] Kansai Med Univ, Dept Urol & Androl, Osaka, Japan

[7] Kagawa Univ, Dept Urol, Sch Med, Takamatsu, Kagawa 760, Japan

[8] Sizuoka City Hosp, Dept Urol, Shizuoka, Japan

[9] Shiga Med Ctr Adults, Dept Urol, Moriyama, Japan

[10] Japanese Red Cross Otsu Hosp, Dept Urol, Otsu, Shiga, Japan

[11] Natl Hosp Org, Kyoto Med Ctr, Dept Urol, Kyoto, Japan

[12] Koseikai Takeda Hosp, Dept Urol, Kyoto, Japan

[13] Tenri Hosp, Dept Urol, Tenri, Nara 632, Japan

[14] Japanese Red Cross Osaka Hosp, Dept Urol, Osaka, Japan

[15] Kansai Elect Power Hosp, Dept Urol, Osaka, Japan

[16] Saiseikai Noe Hosp, Dept Urol, Osaka, Japan

[17] Kobe City Med Gen Hosp, Dept Urol, Kobe, Hyogo, Japan

[18] Nishi Kobe Med Ctr, Dept Urol, Kobe, Hyogo, Japan

[19] Chibune Gen Hosp, Dept Urol, Osaka, Japan

[20] Takarzuka City Hosp, Dept Urol, Takarzuka, Japan

[21] Kawanishi City Hosp, Dept Urol, Kawanishi, Japan

[22] Kyowakai Kyoritsu Hosp, Dept Urol, Osaka, Japan

来源：

JOURNAL OF INFECTION AND CHEMOTHERAPY | 2013年 / 19卷 / 06期

关键词：

Urological surgery; Antimicrobial prophylaxis; Surgical site infection; Urinary tract infection; Remote infection; TRANSURETHRAL PROSTATIC RESECTION; SURGICAL SITE INFECTIONS; ANTIBIOTIC-PROPHYLAXIS; HERNIA REPAIR; RADICAL PROSTATECTOMY; METAANALYSIS; TUMORS; RISK;

D O I：

10.1007/s10156-013-0631-8

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

We prospectively investigated the rates of incidence of surgical site infection (SSI), urinary tract infection (UTI), and remote infection (RI) in 4,677 patients who underwent urological surgery from January to December 2010, including 2,507 endourological cases, 1,276 clean cases, 807 clean-contaminated cases, and 87 contaminated cases involving bowel segments. A single dose of antimicrobial prophylaxis (AMP) was administered in the endourological, clean, and clean-contaminated surgery cases, except for patients who underwent transurethral resection of the prostate (TURP) or percutaneous nephrolithotripsy (PNL). AMP was administered within 72 h in TURP and PNL, and AMP was administered within 48 h in contaminated surgery cases. In cases of endourological surgery, UTI was observed in 4 % and RI in 0 %, and SSI, UTI, and RI were seen in 1 %, 1 %, and 1 %, respectively, of clean surgery cases, in 3 %, 3 %, and 2 %, respectively, of clean-contaminated surgery cases, and in 17 %, 30 %, and 10 %, respectively, of contaminated surgery cases. In multivariate analysis of the risk factors for infection, operative time was a significant risk factor for UTI in endourological surgery, and American Society of Anesthesiologists score and operative time were significant risk factors for RI in clean surgery. No significant risk factor was found in analyses of clean-contaminated and contaminated surgery cases. A single-dose AMP regimen was shown to be effective and feasible for prevention of perioperative infection in urological surgery.

引用

页码：1093 / 1101

页数：9

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