Abstract：
UNASSIGNED: Current guidelines recommend screening and treatment of asymptomatic bacteriuria prior to all urological surgeries breaching the mucosa. But little evidence supports this recommendation. At the least, risk stratification for postoperative UTI to support this strategy is lacking. The aim of this study was to define the associated factors for postoperative febrile infectious complications (UTI or surgical site infection) in urological surgery.
UNASSIGNED: We conducted a retrospective, multicentric study including all consecutive patients undergoing any urological surgery with preoperative urine culture. The primary outcome was the occurrence of a UTI or surgical site infection occurring within 30 days after surgery.
UNASSIGNED: From 2016 to 2023, in 10 centers, 2389 patients were included with 838 (35%) positive urine cultures (mono-/bi-/polymicrobial). Postoperative infections occurred in 106 cases (4.4%), of which 44 had negative urine cultures (41%), 42 had positive mono-/bimicrobial urine cultures (40%), and 20 had polymicrobial urine cultures (19%). In multivariable analysis, UTI during the previous 12 months of surgery (odds ratio [OR] 3.43; 95% CI 2.07-5.66; P < .001), monomicrobial/bimicrobial preoperative urine culture (OR 3.68; 95% CI 1.57-8.42; P = .002), polymicrobial preoperative urine culture (OR 2.85; 95% CI 1.52-5.14; P < .001), and operative time (OR 1.09; 95% CI 1.04-1.15; P < .001) were independent associated factors for postoperative febrile infections.
UNASSIGNED: Positive urine culture, including preoperative polymicrobial urine culture, prior to urological surgery was associated with postoperative infection. Additionally, patients experiencing infectious complications also had a higher incidence of other complications. The effectiveness of systematic preventive antibiotic therapy for a positive urine culture has not been conclusively established.
UNASSIGNED: We conducted a retrospective, multicentric study including all consecutive patients undergoing any urological surgery with preoperative urine culture. The primary outcome was the occurrence of a UTI or surgical site infection occurring within 30 days after surgery.
UNASSIGNED: From 2016 to 2023, in 10 centers, 2389 patients were included with 838 (35%) positive urine cultures (mono-/bi-/polymicrobial). Postoperative infections occurred in 106 cases (4.4%), of which 44 had negative urine cultures (41%), 42 had positive mono-/bimicrobial urine cultures (40%), and 20 had polymicrobial urine cultures (19%). In multivariable analysis, UTI during the previous 12 months of surgery (odds ratio [OR] 3.43; 95% CI 2.07-5.66; P < .001), monomicrobial/bimicrobial preoperative urine culture (OR 3.68; 95% CI 1.57-8.42; P = .002), polymicrobial preoperative urine culture (OR 2.85; 95% CI 1.52-5.14; P < .001), and operative time (OR 1.09; 95% CI 1.04-1.15; P < .001) were independent associated factors for postoperative febrile infections.
UNASSIGNED: Positive urine culture, including preoperative polymicrobial urine culture, prior to urological surgery was associated with postoperative infection. Additionally, patients experiencing infectious complications also had a higher incidence of other complications. The effectiveness of systematic preventive antibiotic therapy for a positive urine culture has not been conclusively established.
摘要：
■目前的指南建议在所有泌尿外科手术破坏粘膜之前筛查和治疗无症状的菌尿。但很少有证据支持这一建议。至少,缺乏支持该策略的术后尿路感染风险分层。这项研究的目的是确定泌尿外科手术中术后发热感染并发症（尿路感染或手术部位感染）的相关因素。
■我们进行了回顾，多中心研究，包括所有连续接受泌尿外科手术的患者，术前尿液培养。主要结果是术后30天内发生尿路感染或手术部位感染。
■从2016年到2023年，在10个中心，2389名患者被纳入838（35％）阳性尿培养物（单/双/多微生物）。术后感染106例(4.4%),其中44例尿液培养阴性（41%），42具有阳性单/双微生物尿培养物(40%),20具有多微生物尿培养物(19%)。在多变量分析中，手术前12个月尿路感染（OR3.43;CI952.07-5.66;P<.001），单抗菌/双抗菌术前尿液培养（OR3.68;CI951.57-8.42;P0.02），多菌术前尿培养（OR2.85；CI951.52-5.14；P<.001），手术时间(OR1.09;CI951.04-1.15;P<.001)是术后发热感染的独立相关因素。
■尿培养阳性，包括术前微生物尿液培养，泌尿外科手术前与术后感染有关.此外,感染并发症患者的其他并发症发生率也较高.尚未确定对尿液培养阳性进行系统预防性抗生素治疗的有效性。
■我们进行了回顾，多中心研究，包括所有连续接受泌尿外科手术的患者，术前尿液培养。主要结果是术后30天内发生尿路感染或手术部位感染。
■从2016年到2023年，在10个中心，2389名患者被纳入838（35％）阳性尿培养物（单/双/多微生物）。术后感染106例(4.4%),其中44例尿液培养阴性（41%），42具有阳性单/双微生物尿培养物(40%),20具有多微生物尿培养物(19%)。在多变量分析中，手术前12个月尿路感染（OR3.43;CI952.07-5.66;P<.001），单抗菌/双抗菌术前尿液培养（OR3.68;CI951.57-8.42;P0.02），多菌术前尿培养（OR2.85；CI951.52-5.14；P<.001），手术时间(OR1.09;CI951.04-1.15;P<.001)是术后发热感染的独立相关因素。
■尿培养阳性，包括术前微生物尿液培养，泌尿外科手术前与术后感染有关.此外,感染并发症患者的其他并发症发生率也较高.尚未确定对尿液培养阳性进行系统预防性抗生素治疗的有效性。
