What to Do About Asymptomatic Bacteriuria in Patients Undergoing Joint Replacement

In a prospective, observational study, asymptomatic bacteriuria before surgery was associated with increased risk for subsequent prosthetic joint infection, but antibiotic therapy did not abrogate this risk.

Information is scarce about whether asymptomatic bacteriuria (ASB) prior to surgery is associated with subsequent development of a prosthetic joint infection (PJI). Nonetheless, it is common practice to obtain a urine culture preoperatively and to treat bacteriuric patients with antibiotics.

To further explore this issue, investigators obtained preoperative urine cultures on all patients undergoing joint-replacement surgery between January 2010 and December 2011 at any of three hospitals in the U.K., Portugal, and Spain. Among 2497 patients, 303 (12.1%) had ASB, defined as ≥10⁵ colony-forming units/mL. The PJI rate during the first year after surgery was 4.3% in those with ASB compared to 1.4% in those without (P=0.001). Among patients with …

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

What to Do About Asymptomatic Bacteriuria in Patients Undergoing Joint Replacement

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Reviewing Author