study of urinary tract infection following diagnostic urologic endoscopic procedures in Alexandria

To study the incidence and possible sources of post-cystoscopy infection. Two hundred patients [140 males and 60 females] were studied during the period from April 1998 and December 1998. They underwent diagnostic cystoscopy in the Urology Department [144] and in the Outpatient Clinic of the Main University Hospital [56], Alexandria Faculty of Medicine. Urine samples were collected pre [200] and post-cystoscopy [123] in the first follow up visit within a week. In addition, swabs from the cystoscope, samples from the Cidex, rinsing water, lubricant gel and glycine were cultured .Urine samples were infected in 48.5% of cases prior to cystoscopy and in 69.9% of cases after cystoscopy. These included all the catheterized patients, 30% and 16.26% respectively. With the exclusion of the catheterized patients, infection rates were 26.43% and 64.08% respectively. Comparing the isolates cultured in both instances, 61.02% of patients who were followed caught new isolate infection. Cystoscopes were infected in 21.5% of occasions. Samples taken from Cidex, rinsing water, lubricant gel and glycine were sterile in only 38.73%, 50.79%, 17.46% and in 4.76% of cases respectively. The infection may be less likely to happen if the procedure was carried early in the day, during the first day of Cidex preparation and using the lubricant gel tube for the first time. The reported post-cystoscopy infection rate is unacceptably high. Every effort has to be done to overcome this problem. Several recommendations are proposed. The added expenses are expected to be much less than that caused by infection caused in the cystoscopy room

Bacteriological monitoring of hemodialysis system: I-pyogenic reactions and bacteremia

This study included 40 patients with chronic renal failure [CRF] on maintenance hemodialysis with arteriovenous fistulae. Bacteriological study was performed on fluid samples [pre- and post-dialysis, 201 samples each]. Blood samples from every patient before and after dialysis and another during any pyrogenic reactions were collected. The occurrence and severity of pyrogenic reactions were found to be affected by the type of isolates, as it occurs mostly with Pseudomonas aeruginosa [82.9%]. Also, it is affected by the bacterial count of the pre- and post-dialysis fluid, as the rate of pyrogenic reactions increased from 5.6% to 45.5% with a count less than 200/ml to 1000/ml in pre-dialysis and from 4.1% to 100% with a count less than 2000/ml to 20000 or more/ml in post-dialysis. The bacterial contaminations in the dialysis fluid with the infected fistulae were considered as the main factors of bacteremia among hemodialysis patients