Endotoxin Contamination of Foley Catheters Associated With Fevers Following Transurethral Resection of the Prostate

In 1980 an investigation was conducted due to an apparent cluster of fevers following transurethral resections of the prostate (TURP), where the presence of prostatitis or urinary tract infections (UTIs) could not account for most cases, and the usage of antimicrobials did not prevent them. When unused, prepackaged, sterilized samples from 13 lots of triple lumen catheters were analyzed, four were found to contain high levels of endotoxin (ET), with a range of 49,150-≥ 6.25 ng/catheter. Additionally, these lots were highly pyrogenic to rabbits. The maximum incidence of febrile patients (42%) correlated with usage of catheters from the lot where ET levels were the highest. The febrile rate for a second urologist, who used single lumen catheters, was less (12/33 v 0/12). Further consideration should be given to sterile operative equipment which may still be pyrogenic.