CODE: 5 - Bacterial flora in patients with benign prostatic hyperplasia and indwelling catheter
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Bartosz Dybowski, Ewa Bres-Niewada, Piotr Kryst, Tomasz Jakubczyk, Andrzej Borkowski

Katedra i Klinika Urologii AM w Warszawie

summary

Introduction. Induction of bacterial resistance is observed also in patients treated with antibiotics in case of persistent infection risk factors, among which indwelling catheter is one of the most common.

Objectives. Urine bacterial flora characteristic in patients with benign prostatic hyperplasia (BPH) with indwelling catheter due to complete urine retention.

Materials and methods. Urine cultures at admission of BPH patients with indwelling Foley catheter due to complete urine retention were analyzed. Males hospitalized in 2004 for surgical treatment of BPH were enrolled.

Results. 60 males with mean catheterization time of 4 months (range one week to two years) were studied. Bacteriuria was found in 50 individuals (83.3%). 67 bacterial strains were identified, among them: Escherichia coli - 15, Enterococcus faecalis - 8, Proteus mirabilis - 8, Enterococcus faecium - 5, Enterobacter cloacae - 3, Serratia marcescens - 3, Pseudomonas aeruginosa - 3, Acinetobacter baumanii - 3, Klebsiella pneumoniae - 3. Resistance to most common ambulatory used antibiotics (both full resistance and mean sensitivity): nitrofurantoin - 52%, ciprofloxacin - 54.5%, cotrimoxazole - 46.1%, amoxicillin with clavulanic acid - 33.9%, fosfomycin - 6.9%. Resistance to second - used antibiotics: amikacin - 19.2%, ceftriaxone - 31.9%, piperacillin with tazobactam - 37% (3/8). No resistance was found to third - used antibiotics. Significant relation between catheterization time and number of urine bacterial strains was found (p=001), unlike antibiotic resistance and catheterization time.

Conclusions. In BPH patients with indwelling catheter infection with bacterial strains resistant to many antibiotics is common. Almost all patients need perioperative antibiotic therapy which increase treatment costs. These patients represent main source of multi resistant bacterial strains in urological department.