[Microbial spectrum of urine before and after transurethral procedures on the prostate in patients with postoperative urinary tract infections].

Abstract

Aim: To evaluate the microbial spectrum of urine before and after transurethral resection of prostate (TURP) in patients with postoperative infectious complications.

Materials and methods: A single-center retrospective observational study between 2016 and 2023 was carried out. Patients who developed urinary tract infections (UTIs) after mono- or bipolar TURP during the hospitalization were included. Bacteriological examination of urine obtained before procedure and after the manifestation of UTI was done in accordance with the Guidelines. In the presence of suprapubic or urethral catheter, the drainage was previously replaced with further microbiological study. The level of significant bacteriuria was more or equal 103 CFU/ml, with a level of significant leukocyturia more or equal 10 per field of view. Statistical analysis was carried out using IBM SPSS Statistics 23.0.

Results: Bacteriuria was not detected in 77.9% of cases of UTIs after TURP. At the same time, according to the preoperative examination in 76.2% of these patients, there was no bacteriuria more or equal 103 CFU/ml. In 17 of 122 men (13.9%) without bacteriuria at baseline, microorganisms were isolated after the development of UTIs. A decrease in bacteriuria level was noted in only 19 of 29 patients (65.5%) who had a positive urine culture before TURP. Only in 4 out of 10 cases of persistent bacteriuria the same microorganism was isolated, while in the remaining 6 cases the initial spectrum was replaced by another bacteria.

Conclusion: Our data indicate a low detection rate of microorganisms in urine of patients with UTIs after TURP using a standard bacteriological study. The data indicate that the standard antibiotic prophylaxis regimen and ongoing anti-infective measures are partly effective in reducing a narrow range of aerobic microorganisms detected preoperatively using standard media, which, however, does not exclude the development of an infectious process.