RESUMO
OBJECTIVES: The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment. DESIGN: Prospective study. MATERIALS AND METHODS: A total of 100 patients (63 men and 37 women) undergoing elective vascular surgery had urine and blood cultures performed for mycoplasmas. Blood cultures were taken preoperatively after urinary tract catheterisation and the urine was collected during catheterisation. The median age of the patients was 67 years (range 42-87). RESULTS: A total of 12 (12%), 5 men and 7 women, had a positive urine culture for mycoplasmas (One patient had Mycoplasma hominis and 11 had Ureaplasma urealyticum isolated). Their median age was 60 years (range 42-76). No blood cultures were positive for Mycoplasma. CONCLUSIONS: Mycoplasmas do not enter the blood-stream after catheterization in sufficient amounts and sufficiently often to be detected by blood-cultures in this small patient sample. The number of vascular patients harbouring mycoplasmas in the urine was low and we found no indication for changes in the prophylactic antibiotic treatment based on these findings.
Assuntos
Bacteriemia/etiologia , Bacteriúria/etiologia , Infecções por Mycoplasma/etiologia , Mycoplasma hominis/isolamento & purificação , Ureaplasma urealyticum/isolamento & purificação , Cateterismo Urinário/efeitos adversos , Procedimentos Cirúrgicos Vasculares , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibioticoprofilaxia , Bacteriemia/prevenção & controle , Bacteriúria/prevenção & controle , Cefuroxima/farmacologia , Cefalosporinas/farmacologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções por Mycoplasma/prevenção & controle , Mycoplasma hominis/efeitos dos fármacos , Estudos Prospectivos , Ureaplasma urealyticum/efeitos dos fármacosAssuntos
Aorta Abdominal/cirurgia , Prótese Vascular/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico , Infecção da Ferida Cirúrgica/diagnóstico , Infecções por Ureaplasma/diagnóstico , Ureaplasma urealyticum , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/cirurgia , Emergências , Eritromicina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecções por Ureaplasma/tratamento farmacológicoRESUMO
Vascular graft infection is one of the most serious complications in vascular surgery. It is associated with mortality rates ranging from 25% to 75% and with morbidity in the form of amputation in approximately 30% of patients. Staphylococcus aureus is the leading pathogen. With conventional laboratory techniques, the percentage of culture-negative yet grossly infected vascular grafts seems to be increasing and is not adequately explained by the prior use of antibiotics. We have recently reported the first case of aortic graft infection with Mycoplasma. We therefore suggest the hypothesis that the large number of culture-negative yet grossly infected vascular grafts may be due to Mycoplasma infection not detected with conventional laboratory technique.
RESUMO
A commercial enzyme immunoassay (Platelia Mycoplasma, Diagnostics Pasteur) for the diagnosis of Mycoplasma pneumoniae [corrected] infections was evaluated and found not to be suitable for the purpose. More than 80% of healthy persons and patients with non-Mycoplasma pneumoniae respiratory infection, all with a negative Mycoplasma pneumoniae complement fixation test, had a positive EIA. Paired sera did not show the positive correlation between a rise in complement fixation titre and the EIA ratio reported by the manufacturer.