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Revista mexicana de urología
On-line version ISSN 2007-4085Print version ISSN 0185-4542
Abstract
MARTINEZ-DELGADO, Guillermo Hérnan; GARZA-GANGEMI, Adrián Mauricio and CASTILLEJOS-MOLINA, Ricardo Alonso. Urinary tract infections after transurethral resection of the bladder: Microbiology, antibiotic resistance, and associated risk factors. Rev. mex. urol. [online]. 2020, vol.80, n.4, e04. Epub July 27, 2022. ISSN 2007-4085. https://doi.org/10.48193/revistamexicanadeurologa.v80i4.640.
Objective:
To analyze the microbiology and incidence of antibiotic resistance in patients that underwent transurethral resection of bladder tumor (TURBT) and identify risk factors for urinary tract infection (UTI) after the procedure.
Methodological design:
A retrospective, analytic, descriptive study on data from 199 patients that underwent TURBT at a tertiary care hospital in Mexico City between 2017-2019. The microbiologic characteristics of isolation frequency and drug-resistance pattern were analyzed before and after the procedure. Binary logistic regression was carried out to identify independent risk factors for UTI.
Results:
Of the 199 patients evaluated, 28 (14%) had a positive urine culture (PUC) before the procedure and the most frequently isolated uropathogens were Escherichia coli (48%), Enterococcus faecalis (24%), and Proteus mirabilis (7%). UTI after TURBT was reported in the 20 patients (10%) that made up group 1. The most frequent pathogen was E. coli (45%), which was resistant to trimethoprim/sulfamethoxazole (60%) and ciprofloxacin (40%). Other isolated pathogens were E. faecalis (27%) and P. mirabilis (9%). The control group included the 179 (90%) patients that did not have a UTI. PUC was statistically significant in relation to necrosis (p=0.001) and muscle-invasive bladder cancer (p=0.03). In the multivariate analysis, PUC was associated with UTI after TURBT (OR 7.04 [95% CI 2.11-23.29]).
Limitations:
A retrospective study with information limited to that in the case records.
Originality and value:
There are few articles on TURBT-associated UTI in the international literature and none in Mexico, the present study being the first.
Conclusions:
The prevalence of UTI after TURBT was 10%. Pre-procedure PUC was the most highly associated risk factor for UTI after TURBT. The most frequently isolated uropathogens were E. coli, E. faecalis, and P. mirabilis. E. coli was most resistant to trimethoprim/sulfamethoxazole (60%) and ciprofloxacin (40%).
Keywords : Transurethral resection of the bladder; Urinary tract infections; Incidence; Antibiotic resistance.
