Zhang Qingyu, Liu Lihua, Sun Wei, Gao Fuqiang, Cheng Liming, Li Zirong
Graduate School of Peking Union Medical College, China-Japan Friendship Institute of Clinical Medicine Graduate School of Peking Union Medical College, China-Japan Friendship Hospital, Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Orthopaedic Department Centre for Osteonecrosis and Joint-preserving & Reconstruction, China-Japan Friendship Hospital, Orthopaedic Department, Chaoyang District, Beijing, China.
Medicine (Baltimore). 2018 Feb;97(7):e9810. doi: 10.1097/MD.0000000000009810.
A high prevalence of asymptomatic bacteriuria exists in patients prior to arthroplasty, and urinary tract infection is considered to be a source of postoperative superficial wound and prosthetic joint infections. There is no consensus whether to screen for and treat asymptomatic bacteriuria before arthroplasty.
To summarize the association between asymptomatic bacteriuria and complications after arthroplasty and to evaluate the clinical benefits of treating asymptomatic bacteriuria prior to arthroplasty.
We systematically searched PubMed, Embase, and the Cochrane Library to retrieve potentially eligible articles. By screening the titles and abstracts of retrieved records and then reading the full texts of the remaining papers, we finally included 8 English-language articles in this systematic review.
Asymptomatic bacteriuria prior to arthroplasty is significantly associated with an increased occurrence of postoperative prosthetic joint and superficial wound infections. However, there is little evidence for direct or hematogenous seeding of urinary infections, and treating asymptomatic bacteriuria before arthroplasty did not decrease the incidence of postoperative infectious complications.
Asymptomatic bacteriuria is not a contraindication for arthroplasty, and the practice of routine preoperative screening for and treatment of asymptomatic bacteriuria should not be continued.
关节置换术前患者中无症状菌尿的患病率较高，尿路感染被认为是术后浅表伤口和人工关节感染的一个来源。对于关节置换术前是否筛查和治疗无症状菌尿尚无共识。
总结无症状菌尿与关节置换术后并发症之间的关联，并评估关节置换术前治疗无症状菌尿的临床益处。
我们系统检索了PubMed、Embase和Cochrane图书馆以检索潜在符合条件的文章。通过筛选检索记录的标题和摘要，然后阅读其余论文的全文，我们最终在本系统评价中纳入了8篇英文文章。
关节置换术前的无症状菌尿与术后人工关节和浅表伤口感染发生率增加显著相关。然而，几乎没有证据表明存在尿路感染的直接或血行播散，并且在关节置换术前治疗无症状菌尿并未降低术后感染并发症的发生率。
无症状菌尿不是关节置换的禁忌证，不应继续进行术前常规筛查和治疗无症状菌尿的做法。
