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Urinary tract infection and indwelling urinary catheters: prospective study in gynecological surgery with antibiotic prophylaxis

Infecção do trato urinário e cateter vesical de demora: um estudo prospectivo em cirurgia ginecológica com antibioticoprofilaxia

ABSTRACT

CONTEXT AND OBJECTIVES:

Urinary tract infections are the most common cause of hospital-acquired infections, and the use of indwelling urinary catheters is a predisposing factor for their development. The aims of this study were to estimate the frequency of pre and postoperative bacteriuria, identify the microorganisms involved, count the colony-forming units, determine the antibiotic sensitivity profile and compare the results from pre and postoperative urinalyses among women undergoing gynecological surgery with implantation of a urinary catheter.

DESIGN AND SETTING:

Non-controlled prospective observational single-cohort epidemiological study carried out at a university hospital.

METHODS:

Urine samples were collected before and 24 hours after catheterization for urinalysis, culturing and antibiotic sensitivity testing. Pre and postoperative urinalyses were compared using Wilcoxon and McNemar non-parametric tests.

RESULTS:

Fifty-one women participated in the study. Escherichia coligrew in six preoperative samples (11.8%) and Klebsiella pneumoniae in one (1.9%), but bacterial growth did not occur in any postoperative sample. Urinalysis showed lower number of pus cells in the postoperative urine samples (P < 0.05). There were no differences in red blood cell counts or in the nitrite and leukocyte esterase tests, between the samples.

CONCLUSION:

Bacteriuria was found in 13.7% of the preoperative samples. Gram-negative bacteria sensitive to most antibiotics were identified. In the postoperative samples, no bacterial growth was observed. Urinalysis only showed significant reduction of leukocyturia in the postoperative period.

KEY WORDS
Urinary tract infections; Bacteriuria; Urinary catheterization; Antibiotic prophylaxis; Gynecologic surgical procedures

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