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Asymptomatic bacteriuria increased risk for prosthetic joint infection
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In patients undergoing total hip or total knee arthroplasty, the presence of asymptomatic bacteriuria before surgery was an independent risk factor for prosthetic joint infection within a year after surgery, according to data from a recent study.
“Preoperative antibiotic treatment did not show benefit, and so postponing surgery or even treating known asymptomatic bacteriuria patients before surgery cannot be recommended,” the researchers wrote in Clinical Infectious Diseases.
The study took place from 2010 to 2011 and included 2,497 patients from three institutions in Portugal, Spain and the United Kingdom. Before surgery, the patients provided urine samples that were cultured to identify those with asymptomatic bacteriuria. Preoperative antibiotic treatment was not mandatory and was given on an individual basis.
Asymptomatic bacteriuria was found in 12.1% of the patients. In the entire cohort of patients, the rate of prosthetic joint infection was 1.7%. In patients with asymptomatic bacteriuria, the rate was 4.3% vs. 1.4% in the patients without asymptomatic bacteriuria (OR=3.23; 95% CI, 1.67-6.27).
In a multivariable analysis, asymptomatic bacteriuria (OR=3.95; 95% CI, 1.52-10.26) and postoperative urinary tract infection (OR=6.64; 95% CI, 1.24-35.64) were independent predictors of prosthetic joint infections. In a subanalysis of patients with asymptomatic bacteriuria, there was no difference in infection rates between those who received treatment and those who did not.
Disclosure: The researchers report no relevant financial disclosures.
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