Postoperativna urinarna infekcija nakon ureteroskopske litotripsije kod bolesnika sa asimptomatskom bakteriurijom
Sažetak
Uvod/Cilj. Postoperativna urinarna infekcija jedna je od najčešćih infektivnih komplikacija ureteroskopske litotripsije. Asimptomatska preoperativna bakteriurija nije kontraindikacija za izvođenje ove metode, ali može biti značajan faktor rizika za nastanak teških oblika postopertivne urinarne infekcije. Metode. Od januara 2010. do decembra 2014. godine, u Klinici za urologiju Vojnomedicinske akademije u Beogradu, analizirano je 389 bolesnika kod kojih je urađena ureteroskopska litotripsija i praćene su postoperativne infektivne komplikacije. Kod 52 bolesnika iz ove grupe sa preoperativnom asimptomatskom bakteriurijom, analizirana je učestalost postoperativne urinarne infekcije. Rezultati. Infektivne komplikacije javile su se kod 18,7% bolesnika, a postoperativnu urinarnu infekciju imalo je 10% bolesnika. Od 52 bolesnika sa asimptomatskom preoperativnom bakteriurijom, postoperativnu urinarnu infekciju imalo je njih 36,5% (χ2 = 46.773; p < 0.001). Kod ovih bolesnika zabeležena je veća učestalost teških oblika postoperativne urinarne infekcije, sindroma sistemskog inflamatornog odgovora (SSIO) i sepse. Zaključak. Asimptomatska preoperativna bakterurija predstavlja značajan faktor rizika za pojavu postoperativne urinarne infekcije nakon ureteroskopske litotripsije i udružena je sa povećanim rizikom za nastanak teških oblika SSIO i sepse. Poželjno je da svi bolesnici kod kojih je indikovana ureteroskopska litotripsija imaju sterilnu urinokulturu, a ako je to nemoguće postići, potreban je poseban oprez i adekvatna antibiotska terapija i profilaksa pre i tokom operativne procedure.
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