Nóbrega Mônica Martins, Auge Antonio Pedro Flores, de Toledo Luis Gustavo Morato, da Silva Carramão Sílvia, Frade Armando Brites, Salles Mauro José Costa
Department of Obstetrics and Gynecology, Santa Casa de São Paulo School of Medicine, São Paulo, São Paulo, Brazil.
Department of Surgery, Santa Casa de São Paulo School of Medicine, São Paulo, São Paulo, Brazil.
Am J Infect Control. 2015 Oct 1;43(10):1035-9. doi: 10.1016/j.ajic.2015.05.031. Epub 2015 Jul 6.
This study was conducted to determine risk factors for infectious complications after urodynamic study (UDS) in women, which can assist clinicians in identifying high-risk subjects who would benefit from antibiotic prophylaxis before UDS.
In this prospective cohort study, we studied 232 women who underwent UDS at Santa Casa de São Paulo School of Medical Sciences between June 2013 and June 2014. Women ranging in age from 26 to 84 years who had urinary incontinence, pelvic organ prolapse, or voiding dysfunction were required to collect urine samples at 7 days before, on the day of, and 3-5 days after UDS. Urine cultures with >100,000 CFU/mL were considered positive. Risk factors associated with bacteriuria and urinary tract infection (UTI) after UDS were evaluated using multivariate analysis with multiple logistic regression.
Two hundred thirty-two out of 257 women were subjected to further analysis. The incidence of bacteriuria, transient bacteriuria, and UTI after UDS was 11.6%, 7.3%, and 4.3%, respectively. On multivariate analysis, hypothyroidism (P = .04), body mass index (BMI) >30 (P = .025), and advanced pelvic organ prolapse (P = .021) were associated with a significantly increased risk of bacteriuria; however, only BMI >30 (P = .02) was associated with an increased risk for UTI.
The rate of infectious complications after UDS was low, and advanced pelvic organ prolapse and hypothyroidism increased the risk for bacteriuria. However, only BMI >30 was associated with bacteriuria and UTI after UDS.
本研究旨在确定女性尿动力学检查(UDS)后感染并发症的危险因素,这有助于临床医生识别那些在UDS前接受抗生素预防可能受益的高危患者。
在这项前瞻性队列研究中,我们对2013年6月至2014年6月间在圣保罗圣卡塔琳娜医学院接受UDS的232名女性进行了研究。年龄在26至84岁之间、患有尿失禁、盆腔器官脱垂或排尿功能障碍的女性,需要在UDS前7天、检查当天以及检查后3 - 5天采集尿液样本。尿培养菌落形成单位(CFU)/毫升>100,000被视为阳性。使用多因素逻辑回归分析评估UDS后与菌尿症和尿路感染(UTI)相关的危险因素。
257名女性中的232名接受了进一步分析。UDS后菌尿症、短暂菌尿症和UTI的发生率分别为11.6%、7.3%和4.3%。多因素分析显示,甲状腺功能减退(P = 0.04)、体重指数(BMI)>30(P = 0.025)和晚期盆腔器官脱垂(P = 0.021)与菌尿症风险显著增加相关;然而,只有BMI>30(P = 0.02)与UTI风险增加相关。
UDS后感染并发症的发生率较低,晚期盆腔器官脱垂和甲状腺功能减退会增加菌尿症风险。然而,只有BMI>30与UDS后的菌尿症和UTI相关。