1053 BACTEREMIA DURING CATHETER MANIPULATION: A PROSPECTIVE STUDY

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder (I)1 Apr 20131053 BACTEREMIA DURING CATHETER MANIPULATION: A PROSPECTIVE STUDY Amar Mohee, Deborah Gascoyne-Binzi, Jonathan Sandoe, and Ian Eardley Amar MoheeAmar Mohee Leeds, United Kingdom More articles by this author , Deborah Gascoyne-BinziDeborah Gascoyne-Binzi Leeds, United Kingdom More articles by this author , Jonathan SandoeJonathan Sandoe Leeds, United Kingdom More articles by this author , and Ian EardleyIan Eardley Leeds, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.639AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An incidence of bacteremia up to 10% is reported during catheter manipulation. We have shown an association between urological procedures and infective endocarditis (Abstract 13-630). We therefore sought to investigate the rate of bacteremia during catheter manipulation in a contemporary series, using contemporary culture and molecular methods. METHODS We conducted an ethically approved cohort study of patients undergoing catheter manipulation [urethral and suprapubic (SP) catheter removal/change]. The catheters were in situ for >3 weeks. A focused medical history was obtained. 20ml of blood was obtained at 4 different time points (pre-procedure, catheter removal, new catheter re-insertion and 0-10 min post-procedure). 15ml of the blood was used for the “culture-method” and it was inoculated into BACTEC™ Plus Aerobic and Anaerobic culture vials, incubated for 10 days and subcultured on day 10. Bacterial identification was done using 16S PCR. The remaining 5ml of blood was used for the “molecular method” and it was used to extract bacterial DNA, using the MolYsis Complete5 kit by MolzymTM. Broad-range 16S PCR (Mastermix 16S by MolzymTM) and Multiplex PCR (Plex-ID by AbbottTM) were performed. Sequencing and mass-spectrometry were respectively used for bacterial identification. A pre-procedure urine sample was cultured. A follow-up telephone interview at 3 months was conducted. RESULTS 49 patients were recruited with a total of 163 blood samples. 34 patients had urethral catheter removal, 7 had urethral catheter change, 7 had SP catheter change and 1 had SP catheter removal. We report bacteremia results based on the culture and PLEX-ID arms of the study. 7/34 patients (20.6%) in the urethral catheter removal group and 1/7 patients (14.3%) in the SP catheter change group had bacteremia. No bacteremia was noted in the urethral catheter change and the SP catheter removal groups. The main organisms causing bacteremia were S. epidermidis and K. oxytoca. Bacteriuria, mainly mixed organisms, was present in all the patients. 9 out of 49 patients (18.4%) required therapeutic antibiotics within 1 month of the procedure. 1 of these patients (11.1%) was bacteremic during his procedure. CONCLUSIONS We report a higher rate of bacteremia during catheter manipulation than previously reported. This subclinical bacteremia is likely to originate from the bacteriuria present in all the patients and may be present for longer periods of time than investigated in this study. The significance of transient bacteremia(s) in relation to more serious infective complications like infective endocarditis is not known. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e432 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amar Mohee Leeds, United Kingdom More articles by this author Deborah Gascoyne-Binzi Leeds, United Kingdom More articles by this author Jonathan Sandoe Leeds, United Kingdom More articles by this author Ian Eardley Leeds, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...