Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

ASYMPTOMATIC URINARY INFECTION IN PATIENTS UNDERGOING ELECTIVE HIP AND KNEE ARTHROPLASTY



Abstract

Introduction and Objectives: The medical literature describes asymptomatic urinary tract infections (UTI) in up to 30% of postmenopausal women. Our aim was to analyze the prevalence of asymptomatic UTI in patients waiting to undergo programmed hip/knee arthroplasty and also the risk of dissemination of the infection through the blood stream.

Materials and Methods: We included 200 patients that had undergone hip/knee arthroplasties in our study (15.1.07–22.10.07). 69.97+/−10.28 years of age, 130 women/70 men. Urine and sediment analysis on entry (12 hours before surgery). Abnormal values: density< 1.006/> 1.030; pH< 4.6/> 7.0; leucocytes and/or positive nitrites; sediment with bacteriuria, piuria and/or > 5 leucocytes/field. If the urine or sediment analysis gave abnormal values: Preoperative quantitative urine culture. If < 10.000 CFUs/ml, no UTI; > 10.000 but < 100.000 urine culture is repeated; > 100.000 CFUs, diagnosis of UTI, specific antibiotics orally for 7 days during the postoperative period. None of the patients underwent urethra catheterization. All received cefazoline 1g i.v/8 hours for 48 hours postoperatively.

Results: Loss to follow-up: 0 patients. If the urine or sediment analysis gave abnormal values: 82/200 patients of 72.59+/−7.32 years of age, 72 women/10 men. In 11/82 patients: no valid uroculture. In 8/82 patients (8/200, 4% of the total series): Pathological urine culture, 4 E. coli, 1 P. aeruginosa, 1 P. putida, 1 K. oxytoca, 1 K. pneumoniae. Treatment: quinolones/amoxicillin-clavulanic acid (not carried out in 3 cases). Up to the now there are no signs of infection in the arthroplasties.

Discussion and Conclusions:

  1. Patients undergoing programmed hip/knee arthroplasties frequently have abnormal preoperative urine analysis.

  2. Up to 4% of patients undergoing programmed hip/knee arthroplasties have preoperative asymptomatic UTI.

  3. Up to now no patient with an abnormal analysis/UTI has developed an arthroplasty infection.

The abstracts were prepared by E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedic Surgery and Traumatology (Revista Española de Cirugía Ortopédica y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología, calle Fernández de los Ríos 108, 28015-Madrid, Spain