Public Health Observatory, Graduate School, Universidad CES, Medellín, Colombia.
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, CIBERESP, Madrid, Spain.
Am J Infect Control. 2019 Dec;47(12):1474-1478. doi: 10.1016/j.ajic.2019.06.024. Epub 2019 Jul 31.
Treatment of asymptomatic bacteriuria (ASB) is recommended in pregnant women and prior to urologic procedures with anticipated mucosal disruption. However, there is still insufficient evidence of the usefulness of treating ASB prior to urologic procedures. Therefore, the aim of this study was to ascertain the risk of infections in patients undergoing urologic surgery based on the presence of ASB.
We conducted a cohort study among patients undergoing urologic surgery at a single center located in Medellín, Colombia. All patients were screened for ASB prior to their procedures. Patients were evaluated for the development of any postoperative infectious complications for up to 30 days after the procedure.
A total of 149 patients were included in this cohort. Incidence of ASB was 14.8%. Thirteen patients (8.72%) developed infectious complications: 3 (13.64%) with ASB and 10 (7.87%) without ABS. Factors associated with postoperative infectious complications included urologic cancers (hazard ratio [HR], 5.26; 95% confidence intervals [CI], 1.24-22.37), urologic interventions in the preceding 3 months (HR, 3.72; 95% CI, 1.02-13.51), and use of antibiotics 3 months prior to surgery (HR, 3.83; 95% CI, 1.01-15.49). Presence of ASB was not associated with postsurgical infectious complications (HR, 1.02; 95% CI, 0.26-3.96).
There was no association between ASB and postoperative infectious complications. There were other factors associated with infectious complications, such as urologic cancer, previous history of urologic manipulation, and antibiotic use.
建议对无症状菌尿症（ASB）孕妇和预计会破坏黏膜的泌尿科手术前进行治疗。然而，在泌尿科手术前治疗 ASB 的有效性仍缺乏足够的证据。因此，本研究旨在确定 ASB 患者接受泌尿科手术后感染的风险。
我们在哥伦比亚麦德林的一家单中心进行了一项队列研究，纳入了所有接受泌尿科手术的患者。所有患者在手术前都进行了 ASB 筛查。术后 30 天内评估患者是否发生任何术后感染性并发症。
本队列共纳入 149 例患者。ASB 的发生率为 14.8%。有 13 例患者（8.72%）发生了感染性并发症：3 例（13.64%）有 ASB，10 例（7.87%）无 ABS。与术后感染性并发症相关的因素包括泌尿系统癌症（危险比[HR]，5.26；95%置信区间[CI]，1.24-22.37）、3 个月内进行的泌尿科干预（HR，3.72；95%CI，1.02-13.51）和手术前 3 个月使用抗生素（HR，3.83；95%CI，1.01-15.49）。ASB 的存在与术后感染性并发症无关（HR，1.02；95%CI，0.26-3.96）。
ASB 与术后感染性并发症之间没有关联。还有其他与感染性并发症相关的因素，如泌尿系统癌症、先前的泌尿系统操作史和抗生素的使用。
