title: Is Preoperative Assessment and Treatment of Asymptomatic Bacteriuria Necessary for Reducing the Risk of Postoperative Symptomatic Urinary Tract Infections After Urologic Surgical Procedures?
abstract: OBJECTIVE
  To evaluate whether it is always necessary to test for the presence of asymptomatic bacteriuria (AB) in patients undergoing urologic surgical procedures, and if present, whether to treat AB with antimicrobial prophylaxis.
  
  
  METHODS
  All patients who underwent urologic surgical procedures from December 2008 to October 2013 in a tertiary referral urologic center were considered for this study. All patients received antimicrobial prophylaxis in line with European Association of Urology guidelines on urologic infections. AB was diagnosed if ≥105colony-forming units/mL were cultured. The population was subdivided into 2 groups: group A, patients with preoperative AB, and group B, patients without AB. Data on postoperative symptomatic urinary tract infections (UTIs) were compared for the 2 groups.
  
  
  RESULTS
  A total of 2201 patients were considered eligible for this study and were analyzed; 668 (30.4%) patients were found to harbor AB (group A), and 1533 (69.6%) patients did not have AB (group B). Microbiologically verified symptomatic postoperative UTIs occurred in 198 patients (8.9%). No difference in terms of overall rate of postoperative symptomatic UTI was found between the 2 groups (group A: 70 [10.4%] and group B: 128 [8.3%]; OR: 1.28 95%CI 0.94-1.74; P = .12), as well as in terms of urosepsis (group A: 2 [0.30%] and group B: 4 [0.26%]; P = 1.0).
  
  
  CONCLUSIONS
  In patients undergoing urologic surgical procedures who are receiving antimicrobial prophylaxis in accordance with European Association of Urology guidelines, the preoperative presence of AB in this study was not associated with a higher incidence of postoperative symptomatic UTI.
authors: Department of Urology, Santa Chiara Regional Hospital, Trento, Italy. Electronic address: ktommy@libero.it.
authors: Tommaso
authors: T
authors: Cai
authors: Department of Urology, University Federico II of Naples, Naples, Italy.
authors: Paolo
authors: P
authors: Verze
authors: Department of Urology, University Federico II of Naples, Naples, Italy.
authors: Alessandro
authors: A
authors: Palmieri
authors: Department of Urology, University of Florence, Florence, Italy.
authors: Mauro
authors: M
authors: Gacci
authors: Department of Microbiology, Santa Chiara Regional Hospital, Trento, Italy.
authors: Paolo
authors: P
authors: Lanzafame
authors: Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
authors: Gianni
authors: G
authors: Malossini
authors: Division of Pathological Anatomy, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy.
authors: Gabriella
authors: G
authors: Nesi
authors: Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland.
authors: Gernot
authors: G
authors: Bonkat
authors: Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Giessen und Marburg GmbH, Justus-Liebig-Universität Giessen, Giessen, Germany.
authors: Florian M E
authors: FM
authors: Wagenlehner
authors: Department of Urology, University Federico II of Naples, Naples, Italy.
authors: Vincenzo
authors: V
authors: Mirone
authors: Department of Urology, University of Pisa, Pisa, Italy.
authors: Riccardo
authors: R
authors: Bartoletti
authors: Department of Urology, Oslo University Hospital, Oslo, Norway.
authors: Truls E Bjerklund
authors: TE
authors: Johansen
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001437:Bacteriuria / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D057234:Preoperative Period; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents