Clinical Aspects of Bacteremia after Manipulation of the Genitourinary Tract

Abstract

The incidence of bacteremia in 300 patients undergoing four different urologic procedures has been studied. The highest incidence (31 %) was seen in patients undergoing transurethral resection of the prostate. The major source of organisms causing bacteremia was preexisting urinary-tract infection. In the absence of a positive urine culture, other sources include prostatitis and the normal urethral flora. Other factors influencing the likelihood of bacteremia include duration of the procedure and, probably, surgical technique. Presumptive specific diagnosis of bacteremia after manipulation might be obtained early in patients by routine culture of urine (and perhaps prostatic fluid) on the day before surgery. This study suggests the desirability of a controlled investigation of the possible effectiveness of individualized prophylactic therapy appropriate for the specific organisms in urine (and possibly prostatic secretion) before manipulation.