Factores asociados a la infección urinaria luego de una prostatectomía
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Date
2021
Authors
Paillier González, Cecilia
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Abstract
La cirugía de próstata es un procedimiento frecuente en varones mayores. Existen diferentes técnicas cuya elección depende de la patología a tratar, experiencia del especialista y disponibilidad técnica. Entre sus complicaciones se encuentran la infección del tracto urinario, que ocasiona incremento en la morbimortalidad y costos para el sistema de salud. El objetivo principal de este estudio fue identificar los factores relacionados con la aparición de infección urinaria luego de la cirugía prostática. Para esto, se realizó un estudio de casos y controles en una población de pacientes sometidos a prostatectomía desde el año 2018 hasta principios de 2020 en la ciudad de Medellín, Colombia. La medida de asociación usada fue Odds, cuyo ajuste para factores de confusión se realizó con una regresión logística y se contrastó con un modelo aditivo generalizado multivariado. Se identificaron 96 casos incidentes de infección del tracto urinario luego de la prostatectomía, para una prevalencia de 9.1%. La frecuencia de solicitud de urocultivo preoperatorio fue de 52.92% (IC: 48.34 – 57.44). Las variables independientes asociadas con el desenlace fueron: solicitud de urocultivo prequirúrgico, número de dosis de profilaxis y tipo de antibiótico. Particularmente se encontró como factor protector, el uso de aminoglucósidos en los esquemas de profilaxis. Los principales gérmenes etiológicos de la infección urinaria fueron: Eschirichia coli, Pseudomonas aeruginosa, Klepsiella pneumoniae, Enterococos faecalis y Serratia marcescens. Basados en lo anterior, este estudio demuestra que factores como la solicitud preoperatoria de urocultivo, el uso de aminoglucósidos y, de manera menos consistente, el número de dosis de profilaxis, influyen en la probabilidad de desarrollar una infección urinaria luego de una prostatectomía
Prostate surgery is a common procedure in older men. There are different techniques whose choice depends on the pathology to be treated, the experience of the specialist and technical availability. Among its complications is urinary tract infection which causes increased morbidity and mortality and costs for the health system. The main objective of this study was to evaluate the factors related to the appearance of urinary tract infection after prostate surgery. For this, a case-control study was conducted in a population of patients undergoing prostatectomy from 2018 to early 2020 in the city of Medellín, Colombia. The association measure used was the Odds, whose adjustment for confounding factors was carried out with a logistic regression and contrasted with a generalized multivariate additive model. Ninety-six incident cases of urinary tract infection were identified after prostatectomy, for a prevalence of 9.1%. The frequency of requesting a preoperative urine culture was 52.92% (CI: 48.34 - 57.44). The variables independently associated with the outcome were: request for preoperative urine culture, number of prophylaxis doses, and type of antibiotic. In particular, the use of aminoglycosides in prophylaxis schemes was found to be a protective factor. The main etiological germs of urinary infection were: Eschirichia coli, Pseudomonas aeruginosa, Klepsiella pneumoniae, Enterococos faecalis and Serratia marcescens. Based on the above, this study shows that factors such as the preoperative request for urine culture, the use of aminoglycosides, and less consistently the number of prophylaxis doses, influence the probability of developing a urinary infection after a prostatectomy
Prostate surgery is a common procedure in older men. There are different techniques whose choice depends on the pathology to be treated, the experience of the specialist and technical availability. Among its complications is urinary tract infection which causes increased morbidity and mortality and costs for the health system. The main objective of this study was to evaluate the factors related to the appearance of urinary tract infection after prostate surgery. For this, a case-control study was conducted in a population of patients undergoing prostatectomy from 2018 to early 2020 in the city of Medellín, Colombia. The association measure used was the Odds, whose adjustment for confounding factors was carried out with a logistic regression and contrasted with a generalized multivariate additive model. Ninety-six incident cases of urinary tract infection were identified after prostatectomy, for a prevalence of 9.1%. The frequency of requesting a preoperative urine culture was 52.92% (CI: 48.34 - 57.44). The variables independently associated with the outcome were: request for preoperative urine culture, number of prophylaxis doses, and type of antibiotic. In particular, the use of aminoglycosides in prophylaxis schemes was found to be a protective factor. The main etiological germs of urinary infection were: Eschirichia coli, Pseudomonas aeruginosa, Klepsiella pneumoniae, Enterococos faecalis and Serratia marcescens. Based on the above, this study shows that factors such as the preoperative request for urine culture, the use of aminoglycosides, and less consistently the number of prophylaxis doses, influence the probability of developing a urinary infection after a prostatectomy
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Paillier González, C. (2021). Factores asociados a la infección urinaria luego de una prostatectomía (tesis de maestría). Universidad Tecnológica de Bolívar.