PS-05-005 Multicenter Investigation of the Microorganisms Involved in Penile Prosthesis Infection: Are the AUA and EAU Guidelines Appropriate for Penile Prosthesis Prophylaxis and Infection Management?

Penile prosthesis infections remain challenging despite advancements in surgical technique, device improvements and adoption of antibiotic prophylaxis guidelines. This study investigated penile prosthesis infection microbiology to consider which changes in practice could decrease infection rates. This retrospective IRB-exempt multi-institutional study reviewed intraoperative cultures obtained at explant or Mulcahy salvage of infected penile prostheses (IPPs). Antibiotic usage was recorded at implantation, admission for infection, and explant/salvage surgery. 227 intraoperative cultures (2002-2016) were obtained at salvage or explant. No culture growth occurred in 33% of cases and Gram-positive and negative organisms were found in 73% and 39% of the positive cultures respectively. Candida species (11.1%), anaerobes (10.5%), and MRSA (9.2%) comprised nearly one third of 153 positive cultures. Multi-organism infections occurred in 25% of positive cultures. Antibiotic regimens at initial implantation were generally consistent with AUA and EAU guidelines. However, the microorganisms identified in this study were covered by these guidelines in only 62-86% of cases. Antibiotic selection at admissions for infection and salvage or explant surgery varied widely compared to those at IPP implantation.