Clinical practices for the management of preoperative asymptomatic bacteriuria in endourological surgery for urolithiasis

Clinical practices for the management of preoperative asymptomatic bacteriuria in endourological surgery for urolithiasis

Johana M. Guachetá-Bomba 1, Carlos H. Abonía-Velasco 1, Martha C. Valderrama-Ríos 2, Wilfredo Donoso-Donoso 1, Andrés F. Puentes-Bernal 1, Juan P. Álzate-Granados 3 , David A. Castañeda-Millán 1

1 Unidad de Urología, Departamento de Cirugía, Facultad de Medicina, Universidad Nacional de Colombia; Grupo de Investigación e Innovación en Urología, Facultad de Medicina, Universidad Nacional de Colombia; Bogotá, Colombia; 2 Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; 3 Grupo de Investigación e Innovación en Urología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia

*Correspondence: David A. Castañeda-Millán. Email: dacastanedam@unal.edu.co

Abstract

Objective: To describe practices from Colombian specialists in urology and infectology for the handling of preoperative asymptomatic bacteriuria (AB) in patients that are candidates for endourological surgery of urolithiasis.

Method: Cross-sectional study, with data collection through a survey-type instrument completed by specialists in urology and infectology in Colombia. Surveys with incomplete responses or participants with clinical practice outside of Colombia were excluded. Statistical analysis was performed in SPSS v25.0. A p < 0.05 was considered significant.

Results: One hundred eighty-seven participants were included, of which 85% were urologists and 15% were infectologists. The most frequent presurgical behavior in the management of preoperative AB was to start targeted antibiotic treatment 72 hours before the procedure and take the patient to surgery within the next three days. Differences were evident in clinical practice (use of postoperative antibiotics, treatment of AB in patients with urinary persion, validity period of the preoperative urine culture, recommendation to defer the procedure until a negative urine culture is obtained) depending on the specialty and surgical or clinical volume.

Conclusions: The present study has identified heterogeneity in the management of AB prior to endourological surgery in Colombia. An opportunity opens up for the development of Colombian recommendations for the management of preoperative AB in urinary lithiasis.

Keywords: Urolithiasis; Bacteriuria; Antibiotic Prophylaxis; Nephrolithotomy percutaneous; Lithotripsy laser

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