povidone-iodine and Bacteriuria

To determine whether antisepsis with povidone-iodine solution applied at the external urethral meatus confers protection against infective complications following transurethral resection of the prostate (TURP) and compare that with antibacterial prophylaxis.. A total of 167 patients with sterile urine undergoing TURP for benign prostatic hyperplasia (BPH) were prospectively randomized into three groups. Group A, had gauze soaked in saline applied at the urethral meatus (control group). In group B, the gauze was soaked in povidone-iodine instead of saline and group C had a single 1 g i.v. injection of cephradine at induction of anaesthesia with no treatment for the meatus. Bacteraemia, post-operative bacteriuria and other infective complications were compared in the three groups. Associations of bacteriuria at catheter removal and intra-operative bacteraemia with infective complications and with long term bacteriuria were also studied.. Bacteriuria rate at catheter removal was not significantly different in the three groups. However, intraoperative bacteraemia and bacterial growth at the external urethral meatus was significantly lower in group C. Bacteriuria at catheter removal was significantly associated with bacterial growth at the meatus but not with long term bacteriuria at 3 months. Bacteriuria at catheter removal could not accurately predict infective complications.. Post-TURP bacteriuria appears to be preceded by bacterial growth at the external urethral meatus. Antisepsis with povidone-iodine solution application at the meatus does not confer adequate protection against meatal bacterial growth as that obtained by prophylactic antibacterials. Nonetheless, neither antibacterial prophylaxis nor local antisepsis could reduce bacteriuria rate in this study.

Topics: Administration, Topical; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Bacteriuria; Cephradine; Escherichia coli Infections; Humans; Male; Povidone-Iodine; Prospective Studies; Surgical Wound Infection; Transurethral Resection of Prostate; Urinary Catheterization

It was shown that prophylactic use of ciprofloxacin (500 mg per os 30 min prior to and 5 days after transrectal multifocal prostatic biopsy) along with topical treatment with 40 ml 1% povidone-iodine and evacuant enema provided negative bacteriological urine analysis in 24 hours for 94.4 per cent of cases. Positive effect was registered for all patients as no urinary tract infections were demonstrated. Transitory fever over 37.5 degrees C was not registered at 67 (97.2 per cent) patients, for the rest cases no changes of the treatment regime were necessary. The results of the trial proves high bacteriological and clinical efficacy of the therapy regimes and allow to recommend its implementation at transrectal biopsy.

Topics: Administration, Topical; Anti-Infective Agents; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Bacteriuria; Biopsy; Ciprofloxacin; Fever; Humans; Male; Povidone-Iodine; Prostate; Rectum; Urinary Tract Infections; Urine

We have evaluated the effect of povidone-iodine (PVP-I) bladder irrigation prior to catheter removal on subsequent bacteriuria. Of 264 patients, 138 received PVP-I irrigation and 126 were controls. Both groups were similar with respect to duration of catheterization and bacteriuria before removal of the catheter. Of 497 cultures taken after catheter removal 99 (20%) were positive. This included 52 of 233 in the control group (22%) and 47 of 264 in the study group (18%). Patients with positive cultures had a significantly longer period of catheterization. Our trial did not demonstrate that PVP-I bladder irrigation before catheter removal reduces subsequent bacteriuria.

Topics: Adult; Aged; Aged, 80 and over; Bacteria; Bacteriuria; Catheters, Indwelling; Female; Humans; Male; Middle Aged; Povidone-Iodine; Staphylococcus epidermidis; Therapeutic Irrigation; Time Factors; Urinary Bladder; Urinary Catheterization

To study the effectiveness of preoperative bladder washing with povidone-iodine to prevent postprostatectomy wound infection.. Patients with an indwelling catheter and scheduled for prostatectomy were divided into two groups. In patients in group 1 (n = 76) the indwelling catheter was simply removed without bladder irrigation. Patients in group 2 (n = 80) had their bladder washed with a nondiluted solution of povidone-iodine before surgery.. One hundred fifty-six consecutive patients with an indwelling catheter and bacteriuria. Mean age was 64 years. All patients had an open prostatectomy during the 12-month study period. Patients undergoing open prostatectomy during the first 6 months of the study had no bladder irrigation and served as the control group. Patients undergoing open prostatectomy during the following 6 months had a bladder instillation with povidone-iodine.. Wound infection appeared in 17 of 76 patients (22.4%) without bladder washing and in 4 of 80 patients (5%) when 50 to 60 ml of the solution was retained in the bladder for 10 to 13 minutes (p = .001). The incidence of postoperative bacteriuria remained unchanged in the control group (100%) but was reduced to 22.5% in the treated group (p = .001). Statistical comparisons of incidence were done using the chi square test.. It has been demonstrated that the use of preoperative bladder instillation of povidone-iodine may be highly effective in the prevention of postprostatectomy wound infection and in reducing the incidence of bacteriuria in patients with an indwelling catheter and urine colonization.

Topics: Administration, Intravesical; Aged; Aged, 80 and over; Bacteriuria; Humans; Male; Middle Aged; Povidone-Iodine; Preoperative Care; Prostatectomy; Surgical Wound Infection; Therapeutic Irrigation; Urinary Bladder Diseases

In a prospective study on 81 patients undergoing transrectal needle biopsy of the prostate, the efficacy of prophylaxis in preventing postbiopsy infectious complications was determined. The patients were divided randomly into four groups, and a comparison of the rate of postbiopsy complications in each group was made. In 11 and 17% of the patients in Group A (n = 18) who received povidone-iodine enema alone, bacteriuria and bacteraemia, respectively, occurred. When parenteral piperacillin alone in Group B (n = 22) was administered, the rates of the same complications were 9 and 14%, respectively, while both rates were as low as 4% in Group C (n = 25) when piperacillin in combination with povidone-iodine enema was given. On the other hand, in 31 and 37.5% of the patients in Group D (n = 16), who served as controls, bacteriuria and bacteraemia developed. The study has thus shown that parenteral piperacillin in combination with povidone-iodine enema significantly reduces the incidence of infectious complications associated with transrectal prostatic biopsy.

Topics: Aged; Bacteriuria; Biopsy, Needle; Drug Therapy, Combination; Enema; Humans; Male; Piperacillin; Povidone-Iodine; Premedication; Prospective Studies; Prostate; Sepsis

To evaluate the efficacy of daily cleansing of the urethral meatus-catheter junction in preventing bacteriuria during closed urinary drainage, randomized, controlled trials of two widely recommended regimens for meatal care were completed. In 32 (16.0 percent) of 200 patients given twice daily applications of a povidone-iodine solution and ointment bacteriuria was acquired, as compared with 24 (12.4 percent) of 194 patients not given this treatment. In 28 (12.2 percent) of 229 patients given once daily meatal cleansing with a nonantiseptic solution of green soap and water bacteriuria was acquired, as compared with 18 (8.1 percent) of 23 patients not given special meatal care. There was no evidence in either trial of a beneficial effect of meatal care. Moreover, each of four different statistical methods indicated that the rates of bacteriuria were higher in the treated groups than in the untreated groups. In subsets of female patients at high risk in both studies significantly higher rates of bacteriuria were noted in the treated groups than in the untreated groups. Current methods of meatal care appear to be hazardous, as well as expensive, and cannot be recommended as measures to control infection.

Topics: Administration, Topical; Adult; Bacteriuria; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Ointments; Povidone-Iodine; Soaps; Urethra; Urinary Catheterization; Urinary Tract Infections

To compare the efficacy of three different rectal cleansing methods for reducing post-procedural infectious complications after transrectal ultrasound (TRUS)-guided prostate biopsy.. A total of 451 consecutive patients who underwent TRUS-guided prostate biopsy were prospectively included in this study. All patients received targeted antimicrobial prophylaxis and underwent bowel preparation through laxative administration. The patients were divided into three groups on the basis of the method of rectal cleansing immediately before the procedure. Group I patients (n=165) underwent cleansing of the perianal skin using povidone-iodine cotton balls; group II patients (n=116) received an injection of povidone-iodine solution (0.1 g/mL) into the anal and lower rectal canals; and group III patients (n=170) received direct manual cleansing of the mucosal surface of the anus and lower rectum using povidone-iodine cotton balls. The three groups were compared regarding the incidence of post-procedural infectious complications, re-hospitalization rates, and mean length of hospital stay using one-way ANOVA, the Chi-square test, and multiple logistic regression analysis.. Post-procedural infectious complications occurred in 21.8%, 11.2%, and 6.5% of groups I, II, and III, respectively (P < .001). The incidence of overall infectious complications was significantly lower in group II (95% CI: 0.232-0.958, OR = 0.472, P = .038) and group III (95% CI: 0.129-0.555, OR = 0.267, P < .001) than in group I. Re-hospitalization rates were 9.7%, 2.6%, and 0.6% in groups I, II, and III, respectively (P < .001). The incidence of re-hospitalization was significantly lower in group II (95% CI: 0.070-0.869, OR = 0.247, P = .029) and group III (95% CI: 0.007-0.421, OR = 0.055, P = .005) than in group I. The mean length of hospital stay was significantly longer in group I than in group III (P = .009).. Combined with targeted antimicrobial prophylaxis, direct manual cleansing of the mucosal surface of the anus and lower rectum using povidone-iodine cotton balls was most effective in preventing post-procedural infectious complications among the three different rectal cleansing methods.

Topics: Administration, Cutaneous; Administration, Topical; Aged; Anti-Infective Agents, Local; Bacteriuria; Humans; Image-Guided Biopsy; Length of Stay; Male; Middle Aged; Patient Readmission; Postoperative Complications; Povidone-Iodine; Prostate; Prostatitis; Pyuria; Rectum; Therapeutic Irrigation; Ultrasonography

To determine if a povidone iodine rectal preparation (PIRP) reduces rates of bacteriuria and bacteremia following transrectal ultrasound guided prostate needle biopsy (TRUS PNB).. Men undergoing TRUS PNB were prospectively enrolled in a study comparing the impact of PIRP versus standard of care (two pills of ciprofloxacin 500 mg). Urine, blood, and rectal cultures were obtained 30 minutes post-procedure with colony forming units (CFUs) determined after 48 hours. Patients were called 7 and 30 days post-procedure to evaluate for infections.. A total of 150 men were accrued into this study including 95 receiving PIRP and 55 the standard of care. Two-thirds of patients were undergoing an initial biopsy, 19% used antibiotics within the previous 6 months, and median number of biopsy cores was 14. There were no differences between the two cohorts with respect to baseline or biopsy characteristics. In the PIRP cohort, rectal cultures before and after PIRP administration noted a 97.2% reduction in microorganism colonies (2.4 x 10 5 CFU/mL versus 6.7 x 10³CFU/mL, p < 0.001). Mean urine bacterial counts following TRUS PNB were 1 CFU/mL for PIRP versus 7 CFU/mL for standard cohort (p < 0.001). Mean serum bacterial counts following TRUS PNB were 0 CFU/mL for PIRP versus 3 CFU/mL for standard of care (p = 0.01). One patient in the PIRP cohort (1.1%) developed post-biopsy sepsis while 3 (5.5%) in the standard cohort had an infectious complication (1 UTI, 2 sepsis).. A PIRP regimen reduced bacteruria and bacteremia following TRUS PNB.

Topics: Administration, Topical; Anti-Infective Agents, Local; Bacteremia; Bacteriuria; Humans; Incidence; Male; Middle Aged; Postoperative Complications; Povidone-Iodine; Prospective Studies; Prostate; Prostatic Neoplasms; Rectum

The purpose of this study was to investigate the efficacy of antiseptics meatal care in preventing catheter-related urinary tract infections (UTIs) in patients with an indwelling urinary catheter in the intensive care unit of Osmangazi University Medical School. One hundred patients were divided into four groups (25 per group) and treated with once or twice daily application of chlorhexidine gluconate or povidone-iodine. A control group was also studied (N=30). Urine samples were taken weekly and cultures were evaluated quantitatively. Meatal swabs were obtained on the first, fifth, and 10th day and determinated semiquantitatively. UTI was defined as bacteriuria with 10(5)cfu/L. Cultures showing no growth or mixed growths were stated as negative for UTI. UTI developed in 16 patients on days two, three, four, five and seven (including control group). Dominant micro-organisms in the meatal area were found to be Candida species. In nine cases the causative agents of UTI were Candida species. It was therefore decided that the use of antiseptics to clean the periurethral area provides no benefit in decreasing the rate of bacteriuria.

Topics: Administration, Topical; Anti-Infective Agents, Local; Bacteriuria; Chlorhexidine; Disinfection; Humans; Intensive Care Units; Patient Care; Pilot Projects; Povidone-Iodine; Turkey; Urinary Catheterization

The incidence of catheter-associated urinary tract infections (UTIs) becomes higher with prolongation of the indwelling period of a catheter. As to the entry of bacteria, ascending UTIs have now attracted attention. In the present study. the metal area was examined bacteriologically and the possibility to use antiseptics for blocking the route of developing infections was investigated. The subjects included 72 patients with an indwelling, urethral catheter inserted post-operatively. These patients were divided into three groups treated with once or twice daily application of povidone-iodine or once daily application of povidone-iodine cream. In these groups, the relation between changes in isolation of bacteria from the meatal area and the incidence of UTI was evaluated. It was found that reduction in bacterial count by antisepsis is effective to prevent ascending UTIs. Moreover, once daily application of povidone-iodine was proven to be effective in male patients. The effective antisepsis in females was twice daily application of povidone-iodine.

Topics: Anti-Infective Agents, Local; Antisepsis; Bacteria; Bacteriuria; Burkholderia; Catheters, Indwelling; Chemoprevention; Colony Count, Microbial; Enterobacteriaceae; Enterobacteriaceae Infections; Enterococcus; Female; Gram-Positive Bacterial Infections; Humans; Incidence; Iodophors; Male; Postoperative Care; Povidone-Iodine; Sex Factors; Staphylococcal Infections; Staphylococcus; Urethra; Urinary Catheterization; Urinary Tract Infections

The incidence of urinary infection in catheterized patients is very important in those undergoing T.U.R. for bladder neck and prostatic obstructions because the risk of jatrogenic defilement, and any method of preventing, reducing or delaying the occurrence of infection in catheterized patients, should be tooking considerations. Between March 1984 and September 1985 300 male patients, requiring catheterization after T.U.R. for out-flow obstruction (80% benign, 40% malignant prostatic disease, 16% bladder-neck obstruction), were introduced to the trial. All patients were managed by closed drainage system and treated, immediately after T.U.R., by continuous bladder irrigation with saline solution of iodine and polyvinylpyrrolidone (1:150-1:50 in 3000 ml) until elective removal of the post-operative catheter; use of antibiotics was restricted to preoperatory stage. At the elective removal of the post-T.U.R. catheter (between 3d and 7th day) the urino-culture in 79% showed no bacteriuria, in 15% showed mild infection (less than 500.000 organisms/ml) and in 6% revealed a severe infection (greater than 500.000 organisms/ml). At the same time 300 other patients-the control group-underwent to T.U.R. for the same diseases (out-flow obstruction) and received pre- and post-operative antibiotics only without P.V.P.-I irrigation. This treatment revealed sterile urine only in 40% of cases and persistent bacteriuria in 60% of cases. This original method in preventing and treating catheter infection of patients operated of T.U.R. has revealed itself as effective, simple, not too much expensive and without severe side effects.

Topics: Administration, Intravesical; Anti-Infective Agents, Urinary; Bacteriuria; Humans; Male; Povidone; Povidone-Iodine; Solutions; Therapeutic Irrigation; Urinary Catheterization; Urinary Tract Infections

We compared a newly developed closed urinary drainage system incorporating a retrograde contamination guard (RCG) with the conventional closed drainage system. The new system contains a solid bactericide (povidone iodine) pellet enclosed in a porous cartridge at the drain port of the urine collection bag. A catheterised rabbit model was used. The urine drainage bags were challenged daily for 8 days with an auxotrophically marked uropathogenic strain of Escherichia coli at the outlet tube. The bag urine was infected with the marked organism in 10 of the 11 rabbits in the control group (conventional collection bags) in 3.8 +/- 1.03 days and in only 1 of the 13 rabbits fitted with the RCG. The RCG effectively prevents contamination of the urine drainage bag and thus may play an important role in reducing the incidence of nosocomial urinary tract infections.

Topics: Animals; Bacteriuria; Equipment Contamination; Escherichia coli Infections; Povidone-Iodine; Rabbits; Urinary Catheterization

The effect of dilute solutions of hydrogen peroxide, povidone-iodine, and acetic acid on a chronic Staphylococcus epidermidis bacteriuria was studied to determine whether direct bladder instillation of the antimicrobial solutions would reduce or eliminate the bacterial count. In vivo instillation of volumes ranging from 50 to 400ml and retained for 30 seconds to 48 hours was evaluated. The effect of the antimicrobial solution on bacterial survival in urine was also measured in vitro through quantitative analysis of the mixture at various times over 24 hours. Instillation of the antimicrobial solutions into the bladder had no measurable effect on the established bacteriuria. Symptoms of discomfort related to such a manipulation were least evident with hydrogen peroxide. In vitro, hydrogen peroxide had an antimicrobial effect as reflected by the reduction of the number of surviving organisms. Despite inefficacy in a case of already established bacteriuria, hydrogen peroxide appears worthy of study as a prophylactic agent against a variety of organisms because it exhibits in vitro efficacy and minimal in vivo symptoms.

Topics: Acetates; Acetic Acid; Adult; Bacteria; Bacteriuria; Humans; Hydrogen Peroxide; Povidone-Iodine; Staphylococcal Infections; Staphylococcus epidermidis; Urinary Bladder

To determine whether the results of voided urine cultures in men are affected by meatal cleansing, midstream sampling, or circumcision status, 308 paired (initial and midstream) specimens were collected from 254 urology clinic patients. Half of the patients cleansed their urethral meatus with povidone-iodine prior to voiding. The circumcision status of all patients was noted. The rates of true bacteriuria (growth of 10(4) or greater colony-forming units/ml urine with a single predominant species) and contamination (growth of 10(3) or greater colony-forming units/ml urine with two or more colonial types) were compared in the various collection technique subgroups. Neither the bacteriuria nor contamination rates were significantly different (p greater than 0.05) in circumcised and uncircumcised patients, or in those who cleansed their meatus and those who did not. Contamination, but not bacteriuria, rates were higher in initial as compared with midstream specimens. These data suggest that the clean-catch midstream void procedure is unnecessary for obtaining routine voided urine culture specimens from men.

Topics: Bacteriuria; Circumcision, Male; Disinfection; Humans; Male; Penis; Povidone-Iodine; Specimen Handling; Urine

Topics: Bacteriuria; Humans; Male; Postoperative Complications; Povidone; Povidone-Iodine; Premedication; Prostatectomy; Therapeutic Irrigation; Urinary Bladder; Urinary Tract Infections

Topics: Bacteriuria; Humans; Microbial Sensitivity Tests; Mycoplasma; Povidone; Povidone-Iodine; Species Specificity; Time Factors; Ureaplasma