STUDIES ON URINARY TRACT INFECTIONS (REPORT III)

Abstract

Urinary infection is a common complication of operation of the bladder and prostate and of drainage by indwelling catheters.
This paper deals with the diagnosis of the infections and change of flora and cross infection.
The investigation of the urine both before and after operation in forty-three cases of bladder surgery showed as follows.
1) A change in bacterial flora was frequently encountered during the prolonged use of an indwelling catheter.
2) Urinary pH had inhibited the degree of bacterial multiplication in urine. Bacterial counts of the most common pathogens of the urinary tract decreased markedly as the pH decreases.
3) By the results of a comparison with the hemagglutinin titer and bacterial count of urine, infection was diagnosed when seven or more successive daily specimens of urine contained more than 5, 000 bacteria per nil.
4) A change in bacterial flora and recurrence would be found frequently during the course of the antibacterial treatment.
It was observed that the pyocyaneus and protens forms were the most frequent forms of infection and that the other forms often replace them e. q., pyocyaneus, proteus in the later post-operative period.
Hospital infection with resistant strains and change of flora appear mostly above all in patients with prostatectomy.
5) The introduction of the combined precautions, an aseptic technique and a closed drainage system reduced the incidence of infection.