title: Bacterial uropathogens and antibiotic susceptibility of positive urine cultures in women with pelvic organ prolapse and urinary incontinence.
abstract: OBJECTIVE
  The aims of the study are to describe the speciation and resistance patterns of positive urinary cultures in women with pelvic floor disorders (PFDs) and those undergoing pelvic reconstructive surgery.
  
  
  METHODS
  Urine cultures with a colony count of >10(5) CFU and <3 isolated uropathogens at a tertiary care Urogynecology practice over a 5-year period for patients with anterior wall dominant pelvic organ prolapse (POP) or urinary incontinence (UI) were identified. Speciation and culture sensitivity data were described for each group and compared to a control group who did not currently have a PFD and who had not undergone pelvic surgery within a year of their positive culture. Additionally, early post-operative UTIs (≤6 weeks) and late post-operative UTIs (>6 weeks but ≤1 year) were compared.
  
  
  RESULTS
  1,306 positive urine cultures over the 5-year period with 51 different species of uropathogens were identified. The percentage of Escherichia coli identified was not significantly different between groups: POP 57.1%, Stress UI 58.4%, Urge UI 54.3%, non-operative controls 54.3%. Cultures obtained from patients on prophylactic antibiotics were significantly less likely to have E. coli (adjusted OR 0.45, 95% CI 0.22, 0.89, P < 0.0216). Non-E. coli cultures were more common in the early post-operative period compared to the late post-operative cultures (69% vs. 41%, adjusted OR 0.33, 95% CI 0.22, 0.48, P < 0.0001).
  
  
  CONCLUSIONS
  Patients with PFDs who develop UTIs have rates of non-E. coli over 40% of the time. Treatment based on culture and antibiotic sensitivity data should be considered.
authors.affiliation: Center for Female Pelvic Medicine & Reconstructive Pelvic Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nathan
authors.initials: N
authors.lastname: Kow
authors.affiliation: Lerner School of Medicine, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Emily
authors.initials: E
authors.lastname: Holthaus
authors.affiliation: Center for Female Pelvic Medicine & Reconstructive Pelvic Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Matthew D
authors.identifier: http://orcid.org/0000-0002-2960-9931
authors.initials: MD
authors.lastname: Barber
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D004926:Escherichia coli / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D019651:Plastic Surgery Procedures; D014549:Urinary Incontinence / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D013520:Urologic Surgical Procedures
chemical_list: D000900:Anti-Bacterial Agents
keywords: pelvic floor disorder; pelvic organ prolapse; pelvic reconstructive surgery; urinary incontinence; urinary tract infection