下部尿路手術後のOpen drainage system における感染予防の検討

Abstract

The patients who had the lower urinary tract surgery followed by postoperative open urinary drainage longer than three days were treated by continuous bladder irrigation with neomycin-polymyxin B solution through the three way bag catheter and perimeatal application of colistin-neomycin foamy aerosol. The following results were obtained. 1. The preventive effect against infection was obviously better than in the open drainage without above treatment. The effect was calculated to be 72.4% in the indewelling within 10 days and 66.7% longer than 10 days. 2. Even in the group having urinary tract infection prior to indwelling, the lower incidence of bacteriuria and the shorter period of indwelling were noted. 3. Bladder rinse with neomycin-polymyxin B through open drainage showed inhibition of the hospital-acquired infection of Pseudomonas and Klebsiella but no effect on Proteus. Serratia, on the contrary, increased both in isolation frequency and drug resistance. 4. Frequency of pyrexia was lower than in the untreated open drainage group. 5. The antibiotics contained in the irrigating solution in a double concentration could not be detected in the peripheral blood even immediately after the surgery (the minimum level for detection: 0.313 g/ml). The absorption from the bladder or the prostatic bed can be neglected. 6. No side effects due to bladder rinse upon the peripheral blood, liver function or renal function were observed.