Abstract
Urosepsis usually develops from a community or nosocomial acquired urinary tract infection (UTI) or during the procedure of various urinary disease such ureterorenoscopy (URS) and percutaneous nephrolithotomy (PCNL). Urosepsis is associated with bacteriuria, Urosepsis due to manipulation during or after percuteneous nephrolithotomy (PCNL) or ureterorenoscopy (URS) or push bang stenting can be catastrophic despite prophylactie antibiotic coverage. This cross sectional study was carried out in Dhaka Medical College Hospital, Dhaka, Bangladesh during the period of July 2011 to June 2013. Sampling technique was purposive and sample size was 70. Among them 23 patients for PCNL and 47 patients for URS were selected by selection criteria. Data were collected by interview of the patients, clinical examinations and laboratory investigations using the research instrument. Data were processed and analyzed using software SPSS (Statistical Package for Social Sciences) version 11.5. Incidence of bacteriuria and urosepsis were measured according to urine and blood culture report. Sensitivity pattern was also observed. According to this study, the incidence of bacteriuria and urosepsis were 17.1% and 5.7% respectively, Of the 70 patients, 12(17.1%) exhibited bacterial growth on urine culture, These 12 patients were then subjected to blood culture and 4(33.3%) of them were found positive. Most (83.4%) of the urine and blood infections (75%) were caused by E. coli. Some widely used antibiotics like moxicillin, Cephalexin and Ciprofloxacin were found 100% resistant in urine culture. Few sensitive antibiotics were Tobramycin (100 %), Amikacin and Ceftazidime (75%). Almost same sensitivity pattern was found in blood culture. In urosepsis, as in other types of sepsis. Urosepsis after PCNL and URS is an important and potentially catastrophic complication. Percuteneous nephrolithotomy (PCNL), Ureterorenoscopy (URS) occurs frequently in this institution. Although the incidence of urosepsis and bacteriuria with resistant organism is low, but it is a burning issue in management in urology practice. The apparent increase in ciprofloxacin resistant organisms appears to be associated with the increased rate of ciprofloxacin resistant organisms are observed in the general population.
Highlights
Urosepsis is a potentially catastrophic complication that can follow Ureterorenoscopy (URS) or percuteneous nephrolithotomy (PCNL)despite sterile preoperative urine and prophylactic antibiotics [1]
Urosepsis is associated with bacteriuria, Urosepsis due to manipulation during or after percuteneous nephrolithotomy (PCNL) or ureterorenoscopy (URS) or push bang stenting can be catastrophic despite prophylactie antibiotic coverage
Urosepsis accounts for approximately 25% of all sepsis cases and may develop from a community or nosocomial acquired urinary tract infection (UTI) or during the procedure of various urinary diseases, such as ureterorenoscopy (URS), percuteneous nephrolithotomy (PCNL), ESWL, push back stenting, even after perurethral catheterization
Summary
Urosepsis is a potentially catastrophic complication that can follow Ureterorenoscopy (URS) or percuteneous nephrolithotomy (PCNL)despite sterile preoperative urine and prophylactic antibiotics [1]. Urosepsis is a potentially catastrophic complication that can follow Ureterorenoscopy (URS) or percuteneous nephrolithotomy (PCNL). Urosepsis accounts for approximately 25% of all sepsis cases and may develop from a community or nosocomial acquired urinary tract infection (UTI) or during the procedure of various urinary diseases, such as ureterorenoscopy (URS), percuteneous nephrolithotomy (PCNL), ESWL, push back stenting, even after perurethral catheterization. Urolithiasis is one of the most common urological diseases; it can be lethal if urinary tract infection associated with obstructed uropathy due to urinary tract calculi results in bacteremia and sepsis [5]. It is proven that the larger the stones, the greater the chance of acquiring infection (6%-10%), as well as an increased chance of postoperative sepsis. Risk of post PCNL sepsis increased by 4 times in patients with HDN and stones >2 cm despite sterile MSU
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