Surgery and instrumental survey urinary and gastrointestinal tract. Microbiemia often occurs when surgery or instrumental studies urinary or gastrointestinal tract that can cause endocarditis. No adequate data to reach specific recommendations are many invazivnyx diagnostic and therapeutic procedures. Based on the limited data, the Committee recommends the following preventive interventions: cystoscopy, prostate surgery, catheterization urethra (especially if the infection), urinary tract surgery, vaginal hysterectomy, surgery of the gall bladder, bowel surgery thick, esophageal dilatation, sclerotherapy esophageal varikoznyh veins, Colonoscopy, upper endoscopy department of gastrointestinal tract with a biopsy, proktosigmoidoskopicheskoy biopsy.
Thus, patients with the risk of bacterial Endocarditis, which are subject to such procedures should receive antibiotics prevention, as shown here.
Microbiemia less frequently accompanies other procedures for urinary and gastrointestinal tract, and evdokardity if developed with these procedures, it is rare. They include: chrezkozhnuyu biopsiyu liver, upper endoscopy department of the gastrointestinal tract or proktosigmoidoskopiyu without a biopsy, barium enema, uncomplicated vaginal delivery and short (inwards and outwards ») bladder catheterization with a sterile urine. If not suspected infection, following gynecological procedure does not require routine prevention: increased uterine cancer and curettage, caesarean section, therapeutic abortion, sterilization, the introduction or removal of intrauterine devices.
Tak as patients with artificial heart valves and e surgically designed system-pulmonalnymi shunt are at particularly high risk of infection Endocarditis can be useful prophylactic use antibibiotikov with these procedures in these patients.
Enterokokki (eg, Streptococcus faecalis) were the most frequent cause of Endocarditis after surgery or instrumental studies urinary and gastrointestinal tract. Although gram-negative bacillary microbiemia can develop after such procedures, these microorganisms rarely cause endocarditis. Thus, antibiotic prophylaxis for the prevention of Endocarditis after these procedures should be directed primarily against enterokokkov.