Department of Internal Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Department of Infectious Disease Surveillance and Control, Clínica Universitaria Colombia, Bogotá, Colombia.
Am J Infect Control. 2018 Feb;46(2):180-185. doi: 10.1016/j.ajic.2017.08.015. Epub 2017 Sep 22.
Despite absence of evidence, in practice, asymptomatic bacteriuria is perceived as a risk factor for surgical site infection (SSI) among patients with cardiac surgery. We aimed to identify whether an association exists between the preoperative presence of asymptomatic bacteriuria or urinary tract infection and SSI in patients undergoing cardiovascular surgery.
This is an analytical study with a retrospective cohort of patients undergoing coronary revascularization or valve replacement surgery. We identified cases of bacteriuria, urinary tract infection, and cardiovascular SSI and adjusted the results according to exposure to antibiotics and known risk factors for SSI using a multivariate logistic regression analysis.
A total of 840 patients were included in the study, of whom 33 (3.9%) had asymptomatic bacteriuria and 13 (1.5%) had urinary tract infections. The incidence of SSI was 9.5% (80 patients), with 2.3% of cases having mediastinitis. In the multivariate analysis, asymptomatic bacteriuria (relative risk, 0.83; 95% confidence interval, 0.26-2.56; P = .74) and urinary tract infection (relative risk, 2.54; 95% confidence interval, 0.60-10.69; P = .20) were not risk factors for SSI. Traditional risk factors were found to increase the risk of SSI.
The presence of bacteriuria is not a risk factor for presenting SSI in cardiovascular surgery. Screening with urinalysis or urine culture would not be recommended for patients undergoing cardiac surgery.
尽管缺乏证据，但在实践中，无症状菌尿被认为是心脏手术患者发生手术部位感染（SSI）的一个危险因素。我们旨在确定接受心血管手术的患者中，术前无症状菌尿或尿路感染与 SSI 是否存在关联。
这是一项分析性研究，回顾性纳入了接受冠状动脉血运重建或瓣膜置换手术的患者队列。我们确定了菌尿、尿路感染和心血管 SSI 的病例，并使用多变量逻辑回归分析根据抗生素暴露和 SSI 的已知危险因素对结果进行了调整。
共有 840 例患者纳入研究，其中 33 例（3.9%）存在无症状菌尿，13 例（1.5%）存在尿路感染。SSI 的发生率为 9.5%（80 例），其中 2.3%的病例为纵隔炎。在多变量分析中，无症状菌尿（相对风险，0.83；95%置信区间，0.26-2.56；P=0.74）和尿路感染（相对风险，2.54；95%置信区间，0.60-10.69；P=0.20）均不是 SSI 的危险因素。传统危险因素被发现会增加 SSI 的风险。
菌尿的存在不是心血管手术发生 SSI 的危险因素。不建议对接受心脏手术的患者进行尿分析或尿培养筛查。
