Refining Bacteriuria as a Risk Factor for Complications After Urethroplasty: Identifying the Culprit

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dc.contributor.authorCalvo, Carlos I.
dc.contributor.authorHoy, Nathan
dc.contributor.authorRourke, Keith F.
dc.date.accessioned2025-01-20T16:16:42Z
dc.date.available2025-01-20T16:16:42Z
dc.date.issued2024
dc.description.abstractOBJECTIVE To determine which bacteria are associated with an increased risk of 90-day complications after urethroplasty. Preoperative bacteriuria is associated with an increased risk of complications after urethroplasty. However, it remains unclear which specific micro-organisms are the primary drivers of this morbidity. METHODS A single-institution, 2-surgeon retrospective review was performed on patients undergoing urethroplasty from 08/2003 to 06/2021. Preoperative bacteriuria was considered significant when the patient had a mixed culture with >= 108 CFU/L or an identifiable micro-organism with >= 106 CFU/L. Descriptive statistics were used to summarize the results and chi-square was used to determine the association between 90-day complications (Clavien >= 2) and clinical characteristics/bacteria. RESULTS Out of 1611 patients, 23.2% (373) had significant preoperative bacteriuria. The most common pathogens included coagulase-negative staphylococcus 18.5% (69), mixed growth 15.8% (59), Escherichia coli 10.7% (40), and Enterococcus 14.2% (53). 7.9% (128/1611) experienced a significant 90-day complication (Clavien-Dindo >= 2). Gram-negative bacilli including E coli, and Morganella sp were associated with higher rates of postoperative complications (14.2%; P = .01) as well as Enterococcus sp (15.1%; P = .03). However, gram-positive cocci (7.9%; P = .97), gram-positive bacilli (11.8%; P = .47), mixed growth (5.1%; P = .54) and Candida (16.7%; P = .27) were not. Neither escalating concentrations of bacteria (P = .44) or number of strains (P = .08) were associated with increased risk of complications. CONCLUSION The main driver of bacteriuria-related complications after urethroplasty are gram-negative bacilli and Enterococcus sp. Patients with bacteriuria related to other micro-organisms can likely proceed with urethroplasty without increased risk of postoperative complications. UROLOGY 186: 1-6, 2024. (c) 2024 Elsevier Inc. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.urology.2024.01.013
dc.identifier.eissn1527-9995
dc.identifier.issn0090-4295
dc.identifier.urihttps://doi.org/10.1016/j.urology.2024.01.013
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90560
dc.identifier.wosidWOS:001231132300007
dc.language.isoen
dc.pagina.final6
dc.pagina.inicio1
dc.revistaUrology
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRefining Bacteriuria as a Risk Factor for Complications After Urethroplasty: Identifying the Culprit
dc.typeartículo
dc.volumen186
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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