Bacteriuria in patients undergoing prostatectomy.

A review of the literature revealed that the reported incidence of bacteriuria arising before and after prostatectomy varied considerably, that there had been little investigation of the organisms isolated, and that the value of chemoprophylaxis at the time of prostatectomy was unproven. Using standard criteria and technical procedures, 248 patients undergoing prostatectomy were studied over a two-and-a-half-year period. Preoperative bacteriuria occurred in 28% of patients. The incidence was significantly increased in patients catheterised before operation (44%) compared with those who had not been catheterised (18%). The incidence of bacteriuria was directly related to the duration of catheter drainage. Postoperatively, 40% of patients with sterile urine at the time of prostatectomy developed bacteriuria. There was an increased prevalence of Enterococcus and coagulase-negative Staphylococcus isolates from postprostatectomy bacteriuria compared with preprostatectomy bacteriuria. Based on this information, suggestions can be made regarding the choice of a suitable chemoprophylactic agent and the optimum timing and duration of its administration.