Pre-operative screening for asymptomatic bacteriuria and associations with post-operative outcomes in patients with spinal cord injury

Margaret A. Fitzpatrick*, Katie J. Suda, Stephen P. Burns, Linda Poggensee, Swetha Ramanathan, Charlesnika T. Evans

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Context: Screening for asymptomatic bacteriuria (ASB) before non-urologic surgery is common but of unclear benefit. Our aim was to describe pre-operative ASB screening and post-operative outcomes in patients with neurogenic bladder due to spinal cord injury (SCI). Methods: This was a descriptive retrospective cohort study of adults with SCI undergoing neurosurgical spine or orthopedic lower limb surgery from 10/1/2012-9/30/2014 at Veterans Affairs (VA) medical centers. National VA datasets and medical record review was used to describe frequency of pre-operative ASB screening, presence of ASB, and association with post-operative surgical site infection, urinary tract infection, and hospital readmission. Results: 175 patients were included. Although over half of patients had pre-operative ASB screening, only 30.8% actually had pre-operative ASB. 15.2% of patients screened were treated for ASB with antibiotics before surgery. Post-operative urinary tract infection (UTI) or surgical site infection (SSI) occurred in 10 (5.7%) patients, and 20 patients (11.4%) were readmitted within 30 days. Neither ASB screening nor the presence of pre-operative ASB were associated with these post-op outcomes (p > 0.2 for all). Conclusion: Pre-operative ASB screening is common in patients with SCI undergoing elective spine and lower limb surgery, although ASB occurs in less than 1/3rd of cases. There were no associations between pre-operative ASB and outcomes. Further studies evaluating the clinical benefit of this practice in patients with SCI should be performed.

Original languageEnglish (US)
Pages (from-to)255-259
Number of pages5
JournalJournal of Spinal Cord Medicine
Volume42
Issue number2
DOIs
StatePublished - Mar 4 2019

Keywords

  • Bacteriuria
  • Orthopedic surgery
  • Spinal cord injury
  • Surgical site infection
  • Urinary tract infection

ASJC Scopus subject areas

  • Clinical Neurology

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