@Article{,
AUTHOR = {Jonathan Bloom, Cristina Fox, Sean Fullerton, Gerald Matthews, John Phillips},
TITLE = {Sepsis after elective ureteroscopy},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {24},
YEAR = {2017},
NUMBER = {5},
PAGES = {9017--9023},
URL = {http://www.techscience.com/CJU/v24n5/60919},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> We sought to determine our rate of 
postoperative sepsis after ureteroscopy as well as identifying 
associative factors, common antibiotic practices along with 
culture data.<br/>
<b>Materials and methods:</b> Records of all patients who 
underwent elective ureteroscopy from 2010 to 2015 at an 
urban tertiary care facility were retrospectively reviewed. 
Factors thought to be associated with infection were 
collected, along with comorbidities depicted as Charlson 
Age-Adjusted Comorbidity Index (CAACI) and American 
Society of Anesthesia (ASA) score. Each patient’s 
course was reviewed to determine if they were treated for 
postoperative sepsis as defined by standardized criteria.<br/>
<b>Results:</b> A total of 345 patients underwent elective 
ureteroscopy with 15 (4.3%) being treated for sepsis 
postoperatively. This resulted in an additional 5.33 ± 3.84 days of hospitalization per patient. The sepsis group grew 
three gram positive organisms and five multi-drug resistant 
(MDR) gram negatives while 7/15 (46.7%) had negative 
cultures. The most common preoperative antibiotics used in 
the sepsis group were cefazolin (60.0%), gentamicin (48.5%) 
and ciprofloxacin (20.0%). Univariate analysis showed 
prior endoscopic procedures, recent treatment for urinary 
tract infections (UTI), multiple comorbidities and longer 
operative times associated with sepsis. However, significant 
variables after multivariate analysis were treatment for UTI 
within the last month, (OR) 7.19 (2.25-22.99), p = 0.001.<br/>
<b>Conclusions:</b> Patients with multiple comorbidities, 
prior endoscopic procedures, longer operative times and 
especially those recently treated for a urinary infection 
should be carefully monitored after ureteroscopy for signs of 
sepsis. Perioperative antibiotics in these patients should be 
selected to cover both MDR organisms and gram positives.},
DOI = {}
}