尿道膀胱鏡検査後の尿路性器感染症に対する予防と対策

Abstract

感染のない男子93例, 女子53例を対象に尿道膀胱鏡検査を行い, 検査後抗生剤は無投与とした.1)尿路感染症は男子1例, 女子2例に認められ, 抗菌剤の投与で軽快した.2)発熱は認めなかった.3)尿道膀胱鏡検査後の尿路感染症の発生頻度は0.5%クロルヘキシジン液6.7%, 2%グルタルアルデヒド液0.9%であった

To prevent urogenital infections occurring after urethrocystoscopy, we have studied the prevalence of these diseases without the use of antibiotic agents subsequent to urethrocystoscopy to determine the relative importance of aseptic procedures and whether administration of antibiotics is really required for this purpose. Patients enrolled in the present study included those undergoing urethrocystoscopy at four hospitals, totaling 146 patients (93 male and 53 female patients). All of these patients were apparently free of urogenital infections prior to urethrocystoscopy, with less than 5 leucocytes per field in urinary sediment, and a bacteria count of less than 10(4) cells/ml. Each patient was checked between 3 and 14 days after examination for 1) presence of clinical symptoms such as fever, bladder irritation symptoms and urethral secretion, 2) urinalysis and urinary culture, and 3) palpation of epididymis, testis and prostatic gland as required. The endoscope was sterilized for 20 to 30 minutes with 2% glutaraldehyde at 3 clinical institutions and with 0.5% chlorhexidine at the other, in a total of 116 and 30 patients, respectively. Sterilized distilled water was used as perfusate. The external urethral meatus of the subject was disinfected with 0.5% chlorhexidine, followed by local anesthesia with xylocaine jelly. Ten minutes after disinfecting the hands of the examiner, urethroscopy and cystoscopy were performed in this order. Urinary tract infection was detected in one male patient (1.1%) and 2 female patients (3.3%). In these cases, the endoscope was sterilized with glutaraldehyde in 2 cases and with chlorhexidine in the other. None of the subjects demonstrated fever or genital infections.(ABSTRACT TRUNCATED AT 250 WORDS)