Risk of infection in patients undergoing urologic surgery based on the presence of asymptomatic bacteriuria: A prospective study.


Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
12 2019
Historique:
received: 19 04 2019
revised: 18 06 2019
accepted: 19 06 2019
pubmed: 4 8 2019
medline: 29 8 2020
entrez: 4 8 2019
Statut: ppublish

Résumé

Treatment of asymptomatic bacteriuria (ASB) is recommended in pregnant women and prior to urologic procedures with anticipated mucosal disruption. However, there is still insufficient evidence of the usefulness of treating ASB prior to urologic procedures. Therefore, the aim of this study was to ascertain the risk of infections in patients undergoing urologic surgery based on the presence of ASB. We conducted a cohort study among patients undergoing urologic surgery at a single center located in Medellín, Colombia. All patients were screened for ASB prior to their procedures. Patients were evaluated for the development of any postoperative infectious complications for up to 30 days after the procedure. A total of 149 patients were included in this cohort. Incidence of ASB was 14.8%. Thirteen patients (8.72%) developed infectious complications: 3 (13.64%) with ASB and 10 (7.87%) without ABS. Factors associated with postoperative infectious complications included urologic cancers (hazard ratio [HR], 5.26; 95% confidence intervals [CI], 1.24-22.37), urologic interventions in the preceding 3 months (HR, 3.72; 95% CI, 1.02-13.51), and use of antibiotics 3 months prior to surgery (HR, 3.83; 95% CI, 1.01-15.49). Presence of ASB was not associated with postsurgical infectious complications (HR, 1.02; 95% CI, 0.26-3.96). There was no association between ASB and postoperative infectious complications. There were other factors associated with infectious complications, such as urologic cancer, previous history of urologic manipulation, and antibiotic use.

Sections du résumé

BACKGROUND
Treatment of asymptomatic bacteriuria (ASB) is recommended in pregnant women and prior to urologic procedures with anticipated mucosal disruption. However, there is still insufficient evidence of the usefulness of treating ASB prior to urologic procedures. Therefore, the aim of this study was to ascertain the risk of infections in patients undergoing urologic surgery based on the presence of ASB.
METHODS
We conducted a cohort study among patients undergoing urologic surgery at a single center located in Medellín, Colombia. All patients were screened for ASB prior to their procedures. Patients were evaluated for the development of any postoperative infectious complications for up to 30 days after the procedure.
RESULTS
A total of 149 patients were included in this cohort. Incidence of ASB was 14.8%. Thirteen patients (8.72%) developed infectious complications: 3 (13.64%) with ASB and 10 (7.87%) without ABS. Factors associated with postoperative infectious complications included urologic cancers (hazard ratio [HR], 5.26; 95% confidence intervals [CI], 1.24-22.37), urologic interventions in the preceding 3 months (HR, 3.72; 95% CI, 1.02-13.51), and use of antibiotics 3 months prior to surgery (HR, 3.83; 95% CI, 1.01-15.49). Presence of ASB was not associated with postsurgical infectious complications (HR, 1.02; 95% CI, 0.26-3.96).
CONCLUSIONS
There was no association between ASB and postoperative infectious complications. There were other factors associated with infectious complications, such as urologic cancer, previous history of urologic manipulation, and antibiotic use.

Identifiants

pubmed: 31375294
pii: S0196-6553(19)30655-8
doi: 10.1016/j.ajic.2019.06.024
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1474-1478

Informations de copyright

Copyright © 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Jorge A Ramos-Castaneda (JA)

Public Health Observatory, Graduate School, Universidad CES, Medellín, Colombia. Electronic address: ramos.jorge@uces.edu.co.

Alberto Ruano-Ravina (A)

Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, CIBERESP, Madrid, Spain.

L Silvia Munoz-Price (LS)

Division of Infectious Diseases, The Medical College of Wisconsin, Milwaukee, WI, USA.

Rodrigo Toro-Bermúdez (R)

Department of Urology, Clínica CES; Universidad CES, Medellín, Colombia.

David Ruiz-Londoño (D)

Department of Urology, Clínica CES; Universidad CES, Medellín, Colombia.

Angela M Segura-Cardona (AM)

Public Health Observatory, Graduate School, Universidad CES, Medellín, Colombia.

Elkin V Lemos-Luengas (EV)

Public Health Observatory, Universidad CES, Medellín, Colombia.

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Classifications MeSH