Is asymptomatic bacteriuria a risk factor for prosthetic joint infection?

April 6, 2017 at 8:30 am

Clin Infect Dis. 2014 Jul 1;59(1):41-7.

Sousa R1, Muñoz-Mahamud E2, Quayle J3, Dias da Costa L1, Casals C2, Scott P3, Leite P1, Vilanova P2, Garcia S2, Ramos MH4, Dias J5, Soriano A6, Guyot A7.

Author information

Departments of Orthopaedics.

1 Department of Orthopaedics

2 Department of Orthopaedics, Bone and Joint Infection Unit.

3 Department of Orthopaedics.

4 Microbiology, Centro Hospitalar do Porto-Hospital de Santo António.

5 Department of Biostatistics, Administração Regional de Saúde do Norte, Porto, Portugal.

6 Department of Infectious Diseases, Hospital Clínic of Barcelona, Spain.

7 Department of Microbiology, Frimley Park Hospital, Frimley, United Kingdom.

Abstract

BACKGROUND:

Infection is a major complication after total joint arthroplasty. The urinary tract is a possible source of surgical site contamination, but the role of asymptomatic bacteriuria (ASB) before elective surgery and the subsequent risk of infection is poorly understood.

METHODS:

Candidates for total hip or total knee arthroplasty were reviewed in a multicenter cohort study. A urine sample was cultured in all patients, and those with ASB were identified. Preoperative antibiotic treatment was decided on an individual basis, and it was not mandatory or randomized. The primary outcome was prosthetic joint infection (PJI) in the first postoperative year.

RESULTS:

A total of 2497 patients were enrolled. The prevalence of ASB was 12.1% (303 of 2497), 16.3% in women and 5.0% in men (odds ratio, 3.67; 95% confidence interval, 2.65-5.09; P < .001). The overall PJI rate was 1.7%. The infection rate was significantly higher in the ASB group than in the non-ASB group (4.3% vs 1.4%; odds ratio, 3.23; 95% confidence interval, 1.67-6.27; P = .001). In the ASB group, there was no significant difference in PJI rate between treated (3.9%) and untreated (4.7%) patients. The ASB group had a significantly higher proportion of PJI due to gram-negative microorganisms than the non-ASB group, but these did not correlate to isolates from urine cultures.

CONCLUSIONS:

ASB was an independent risk factor for PJI, particularly that due to gram-negative microorganisms. Preoperative antibiotic treatment did not show any benefit and cannot be recommended.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4305141/pdf/ciu235.pdf

Advertisements

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Infecciones sitio quirurgico, Infecciones urinarias, Metodos diagnosticos, Profilaxis Antibiótica en Cirugía - PAC, REPORTS, Update.

Estimating the burden of invasive and serious fungal disease in the United Kingdom Gram-negative prosthetic joint infections: risk factors and outcome of treatment.


Calendar

April 2017
M T W T F S S
« Mar   May »
 12
3456789
10111213141516
17181920212223
24252627282930

Most Recent Posts


%d bloggers like this: