Enterococcus fecalis was the most common causative organism, followed by Escherichia coli, then Klebsiella pneumoniae. The highest antibiotic resistance was observed for penicillin and fluoroquinolones, while the highest sensitivity was observed for aminoglycosides, trimethoprim-sulfamethoxazole, and cefepime. Fungal infections represented 30% of UTIs in the first 30-days after surgery. We found that patients who received neobladders, had longer hospital stays, received adjuvant therapy, developed postoperative hydronephrosis, CKD or ureteroileal anastomotic stricture are at a higher risk of developing UTIs after robot-assisted radical cystectomy. Recent studies suggested that the use of prophylactic antibiotics in the first 30 days following RC was significantly associated with lower UTIs and readmissions from urosepsis after surgery. While it is still controversial whether antibiotic prophylaxis after surgery is needed or not, our data suggest that patients who are at higher risk of UTIs may benefit from postoperative antibiotic prophylaxis.
Written by: Ahmed Aly Hussein, MD, Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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