147 Pre-Operative Urine Culture for Endourology Surgeries

Published Date: 30th August 2023

Publication Authors: Maniarasu S, McNicholas DP, Iordan N

Aim
Our aim was to reduce post-operative endourology infection rates by screening all patient pre-operatively with urine culture. Our local guidelines recommend single dose Gentamicin for prophylaxis prior to endourology procedures. Pre-operative urine culture can identify patients with positive cultures to be treated prior to surgery and to identify multi-resistant microorganisms to aid alternative antibiotic prophylaxis choice.

Methods
We identified patients that underwent elective endourological surgeries in a 3-month period (July-September2021). We identified if pre-operative urine cultures were performed, if the cultures were positive and were they treated appropriately. We identified if any patients had re-admissions postoperatively within 30 days of their procedure with UTI. We identified if the microorganism grown in the culture was resistant to Gentamicin and if an alternative prophylaxis was given pre-operatively.

Results
104 patients were identified. 65 had pre-operative cultures done. Of the 39 patients that did not have cultures done, 2 were re-admitted within 30 days with UTI. 14 pre-operative cultures were positive (21.5%) and was treated with a course of antibiotics per sensitivities and Gentamicin pre-operatively. 4 were resistant to Gentamicin (6.2%). An alternative prophylactic antibiotic was used per microbiologist’s advice for those resistant. No one was re-admitted with a UTI within 30 days in the group that had pre-operative cultures done.

Conclusion
Around 1 in 5 urine cultures done was positive for growth. Almost a third of this was resistant to Gentamicin and this aided our choice of alternative prophylactic treatment. By performing pre-operative cultures, we reduced our postoperative infection complication and re-admission rates.

 

Maniarasu, S.; McNicholas, DP.; Iordan, N. (2023). 147 Pre-Operative Urine Culture for Endourology Surgeries. British Journal of Surgery. 110(Suppl. 7), p.vii170. [Online]. Available at: https://doi.org/10.1093/bjs/znad258.712 [Accessed 28 February 2024].

 

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