Department of Orthopedics, the People's Hospital of Guangxi Zhuang Autonomous Region, No.6 Taoyuan Road, Nanning, 530001, Guangxi Zhuang Autonomous Region, China.
Guangxi University of Chinese Medicine, No.179 Mingxiu Dong Road, Nanning, 530001, Guangxi Zhuang Autonomous Region, China.
Surgeon. 2021 Jun;19(3):175-182. doi: 10.1016/j.surge.2020.04.010. Epub 2020 May 22.
Urinary tract infection (UTI) are very common in the general population, however it is unclear whether UTI is a risk factor of prosthetic joint infection (PJI). Our purposes were: (1) To determine whether UTI is a risk factor of PJI after joint replacement, and (2) to determine whether the microorganisms causing PJI and UTI are the same.
PubMed, Web of Science, the Cochrane Library, and EMBASE were searched systematically for studies. The effect sizes of RR were calculated for included studies that reported raw counts with 95% CIs. The aim 1 of the study is a meta-analysis; the aim 2 is a systematic review.
The aim 1 indicated that the risk of PJI was significantly higher in the UTI group than in the control group (RR = 3.17; 95% CI, 2.19-4.59). The aim 2 indicated that the microorganisms of UTI and PJI were the same in the same patient, and these included Enterococcus faecalis, and Pseudomonas, which supports the theory of PJI occurring via the haematogenous route from the genitourinary tract that harbours bacteria in UTI.
This study identified UTI as being significantly associated with PJI after joint arthroplasty and PJI occurring via the haematogenous route from the genitourinary tract harbouring bacteria in UTI. Therefore, postponing surgery and even treating patients with known UTI preoperatively are recommended.
尿路感染（UTI）在普通人群中非常常见，但 UTI 是否是人工关节感染（PJI）的危险因素尚不清楚。我们的目的是：（1）确定在关节置换后 UTI 是否是 PJI 的危险因素，以及（2）确定引起 PJI 和 UTI 的微生物是否相同。
系统检索了 PubMed、Web of Science、Cochrane 图书馆和 EMBASE 中的研究。对于报告了原始计数和 95%CI 的纳入研究，计算了 RR 的效应大小。该研究的目的 1 是荟萃分析；目的 2 是系统评价。
目的 1 表明，UTI 组的 PJI 风险明显高于对照组（RR=3.17；95%CI，2.19-4.59）。目的 2 表明，同一患者的 UTI 和 PJI 的微生物相同，包括粪肠球菌和假单胞菌，这支持了 PJI 通过血液传播途径从含有细菌的尿路感染发生的理论。
本研究确定 UTI 与关节置换后 PJI 显著相关，PJI 是通过血液传播途径从含有细菌的尿路感染发生的。因此，建议推迟手术，甚至在术前治疗已知的 UTI 患者。
