Post-Operative Urinary Tract Infections After Radical Cystectomy: Incidence, Pathogens, and Risk Factors

dc.contributor.authorSandberg, Maxwellen
dc.contributor.authorVancavage, Rachelen
dc.contributor.authorRefugia, Justin M.en
dc.contributor.authorUnderwood, Gavinen
dc.contributor.authorYe, Emilyen
dc.contributor.authorMarie-Costa, Claudiaen
dc.contributor.authorRodriguez, Raineren
dc.contributor.authorProkopiou, Nicosen
dc.contributor.authorBissette, Randallen
dc.contributor.authorDavis III, Ronalden
dc.contributor.authorHemal, Ashoken
dc.contributor.authorRodriguez, Alejandro R.en
dc.date.accessioned2024-11-27T13:32:11Zen
dc.date.available2024-11-27T13:32:11Zen
dc.date.issued2024-11-12en
dc.date.updated2024-11-26T17:42:38Zen
dc.description.abstract<b>Background</b>: The incidence of urinary tract infections (UTIs) after radical cystectomy (RC) with urinary diversion (UD), the typical pathogens, and associated patient risk factors have not been well documented. In this study, we examined the incidence of post-op UTIs after RC to identify associated risk factors. <b>Methods</b>: Single-center, retrospective case series of 386 patients with bladder cancer who underwent RC with UD between 2012 and 2024. The primary objective was UTI incidence, defined by the frequency of patients with urine culture with &gt;10<sup>5</sup> colony-forming units per high-powered field, spanning from post-op day 0 (POD0) to 90 days after discharge. Isolated pathogens were reported. Risk factors for UTIs were assessed. <b>Results</b>: The average age was 69 years old at surgery, and patients were predominantly male (80%). The cumulative incidence of post-op UTIs was 14%, among which 12 patients had more than one UTI. The UTI incidence was 2%, 8%, and 7% during the immediate post-op period, within 30 days, and within 31&ndash;90 days, respectively. Isolated pathogens included <i>Escherichia coli</i> (26%), <i>Enterococcus faecalis</i> (24%), <i>Klebsiella pneumoniae</i> (21%), and <i>Pseudomonas species</i> (21%). In the immediate post-op period, female sex was the only significant risk factor. At 31 to 90 days, cutaneous ureterostomy UD was the predominant risk factor for UTIs. For ileal conduit patients, those with a Wallace ureteral anastomosis were associated with UTI 31&ndash;90 days from discharge for RC. <b>Conclusions</b>: Our retrospective data suggests the incidence of UTIs and their causative pathogens after RC differ based on post-operative time points and vary according to different patient risk factors.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationSandberg, M.; Vancavage, R.; Refugia, J.M.; Underwood, G.; Ye, E.; Marie-Costa, C.; Rodriguez, R.; Prokopiou, N.; Bissette, R.; Davis III, R.; Hemal, A.; Rodriguez, A.R. Post-Operative Urinary Tract Infections After Radical Cystectomy: Incidence, Pathogens, and Risk Factors. J. Clin. Med. 2024, 13, 6796.en
dc.identifier.doihttps://doi.org/10.3390/jcm13226796en
dc.identifier.urihttps://hdl.handle.net/10919/123660en
dc.language.isoenen
dc.publisherMDPIen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.titlePost-Operative Urinary Tract Infections After Radical Cystectomy: Incidence, Pathogens, and Risk Factorsen
dc.title.serialJournal of Clinical Medicineen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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