最近の泌尿器科領域における感染症および術創感染予防対策 第2報：下部尿路手術後創感予防について

Abstract

Thirty-five patients who received operation of lower urinary passages at the Department of Urology, Kyoto Prefectural University of Medicine, from January 1974 to December 1974 were studied after administration of cephalothin (CET) and concomitant administration of sulbenicillin (SB-PC) and CET for prevention of postoperative infections. The patients consisted of 3 cases of suprapubic cystotomy (suprapubic lithotomy), 2 cases of ureteroneocystostomy, 5 cases of partial cystectomy, 5 cases of bladder neck plasty and 20 cases of subcapsular prostatectomy. Of these 17 patients were given CET alone and 18 given SB-PC plus CET. Ten (58.8%) patients receiving CET alone responded to therapy. Of them, 6 patients showed an excellent response. 17 (94.5%) patients receiving SB-PC plus CET, responded to therapy and 12 of them showed an excellent response. Bacterial cultures were obtained from 21 of the 35 cases, which consisted of 12 cases (57.1%) of Pseudomonas spp., 6 cases (28.6%) of E. coli, 4 cases (19%) of Streptococcus faecalis, 3 cases (14.3%) of Klebsiella, 3 cases (14.3%) of Candida spp., 1 case (4.8%) of Enterobacter and 1 case (4.8%) of Citrobacter. When the results are seen in comparison with the bacterial species isolated from the urine of the patients who visited or hospitalized at the Department of Urology of this university from 1964 to 1973, an increase in the number of gram-negative bacilli, especially of Pseudomonas, E. coli and Klebsiella, was noteworthy. The results indicate that the concomitant use of SB-PC and CET affords a good clinical response to prevention of the infections after operation of lower urinary passages as Pseudomonas spp. are highly susceptible to SB-PC and E. coli and Klebsiella are highly susceptible to CET.