PDF(Pubmed)
Abstract：
Periprosthetic joint infection (PJI) is a significant issue in orthopedic surgery. Urinary tract infections (UTIs) and asymptomatic bacteriuria (ASB) have been identified as potential causes of PJI; however, evidence is inconclusive. Understanding these relationships is critical for improving therapy and patient outcomes. A systematic review was performed by conducting searches from PubMed, EBSCO, ProQuest, and manual searching with adherence to the Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 guideline. Studies that reported UTI/ASB and PJI were included. Meta-analysis was conducted using a random-effects model using RevMan 5.4 software. A total of 14 studies were included with UTIs and ASB showed an overall association with increased risk of PJI (odds ratio [OR]: 1.84, 95% confidence interval [CI]: 1.14-2.99, P = 0.01). However, subgroup analysis for UTIs and ASB was not significant. Further analysis of UTIs in total hip arthroplasty (THA) surgery showed a significant association (OR: 1.76, 95% CI: 1.57-1.96) with PJI. Preoperative UTIs timing between 0 and 2 weeks before surgery showed an increased risk of PJI (OR: 1.45, 95% CI: 1.35-1.55). Antibiotic treatment in ASB did not significantly impact PJI rates. Urine and PJI sample cultures in four studies showed no correlation of microorganisms between the two sites. According to recent evidence, a statistically significant association was found between UTIs and PJI in patients who underwent THA surgery. However, ASB did not yield significant results in relation to PJI. These results should be supported by larger and well-designed studies to make proper clinical suggestion in future. For further research, it is recommended to adopt standardized criteria for outcome measurement and to involve larger sample sizes to enhance the reliability and generalizability of findings.
摘要：
假体周围关节感染（PJI）是骨科手术中的重要问题。尿路感染（UTI）和无症状性菌尿（ASB）已被确定为PJI的潜在原因；然而，证据不足.了解这些关系对于改善治疗和患者预后至关重要。通过从PubMed进行搜索进行系统审查，EBSCO,ProQuest,和手动搜索，并遵守2020年系统评价和荟萃分析指南的首选报告项目。包括报告UTI/ASB和PJI的研究。采用RevMan5.4软件建立随机效应模型进行Meta分析。共有14项研究纳入了UTI和ASB，显示总体上与PJI风险增加相关（比值比[OR]：1.84，95%置信区间[CI]：1.14-2.99，P=0.01）。然而,UTI和ASB的亚组分析不显著.对全髋关节置换术（THA）手术中UTI的进一步分析显示，与PJI存在显着相关性（OR：1.76，95％CI：1.57-1.96）。术前UTI的时间在手术前0到2周之间显示PJI的风险增加（OR：1.45，95％CI：1.35-1.55）。ASB中的抗生素治疗对PJI发生率没有显著影响。四项研究中的尿液和PJI样品培养物显示两个位点之间的微生物没有相关性。根据最近的证据,在接受THA手术的患者中,发现UTI和PJI之间存在统计学显著关联.然而,ASB没有产生与PJI相关的显著结果。这些结果应该得到更大的和精心设计的研究的支持，以便将来提出适当的临床建议。为了进一步研究，建议采用标准化的结果测量标准，并涉及更大的样本量，以提高结果的可靠性和普遍性。
