Preoperative urine culture with contaminants is not associated with increased risk for urinary tract infection after ureteroscopic stone treatment.


Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
15 Mar 2024
Historique:
received: 21 04 2023
accepted: 16 01 2024
medline: 18 3 2024
pubmed: 15 3 2024
entrez: 15 3 2024
Statut: epublish

Résumé

We aimed to assess whether the presence of contaminants in the pre-operative urine culture (preop-UC) predicts postoperative urinary tract infection (postop-UTI) in patients undergoing elective ureteroscopy with laser lithotripsy. A retrospective chart review was performed from 01/2019 to 12/2021 examining patients with unilateral stone burden ≤ 2 cm who underwent ureteroscopy with laser lithotripsy and had a preop-UC within 3 months. Positive, negative, contaminated, and polymicrobial definitions for UCs were established in accordance with current guidelines. Patients with positive and polymicrobial cultures were excluded. Postop-UTI was defined as the presence of urinary symptoms and a positive UC within 30 days of the procedure. Multivariable logistic regression models were utilized to evaluate risk factors for contamination in the preop-UC and the risk of postop-UTI. A total of 201 patients met the inclusion-exclusion criteria. Preop-UC was negative in 153 patients and contaminated in 48 patients. Significant contaminant-related factors included female gender and increased BMI. Postop-UTI was diagnosed in 3.2% of patients with negative preop-UCs and 4.2% of patients with contaminants, with no difference between groups (p = 0.67). The regression model determined that the presence of contaminants in preop-UC failed to predict postop-UTI (OR 0.69, p = 0.64). The presence of contaminants in preop-UCs is not associated with an increased risk of postop-UTIs after ureteroscopy. Our study supports that contaminants in the preop-UC can be interpreted as a negative UC in terms of postop-UTI risk stratification. Preoperative antibiotics should not be prescribed for patients undergoing uncomplicated ureteroscopy for stone surgery in the setting of a contaminated preop-UC.

Identifiants

pubmed: 38488875
doi: 10.1007/s00345-024-04793-w
pii: 10.1007/s00345-024-04793-w
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

159

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Willian Ito (W)

Department of Urology, The University of Kansas Health System, Kansas City, KS, USA.

Nicholas Choi (N)

School of Medicine, The University of Kansas, Kansas City, KS, USA.

George Letner (G)

School of Medicine, The University of Kansas, Kansas City, KS, USA.

Nicholas Genz (N)

School of Medicine, The University of Kansas, Kansas City, KS, USA.

Dillon Prokop (D)

School of Medicine, The University of Kansas, Kansas City, KS, USA.

Crystal Valadon (C)

Department of Urology, The University of Kansas Health System, Kansas City, KS, USA.

Mihaela E Sardiu (ME)

Department of Biostatistics and Data Science, University of Kansas, 3901 Rainbow Boulevard, Mail Stop #3016, Kansas City, KS, 66160, USA.

Holly Smith (H)

Department of Biostatistics and Data Science, University of Kansas, 3901 Rainbow Boulevard, Mail Stop #3016, Kansas City, KS, 66160, USA.

Bristol B Whiles (BB)

Department of Urology, The University of Kansas Health System, Kansas City, KS, USA.

Wilson R Molina (WR)

Department of Urology, The University of Kansas Health System, Kansas City, KS, USA. wmolina@kumc.edu.

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