Positive urine culture tied to postsurgery infections

Postoperative infections tend to occur more often in patients with a positive urine culture, including preoperative polymicrobial urine culture, prior to urological surgery, reports a study. In addition, those with infectious complications are prone to experiencing other complications. 

This retrospective, multicentric study included all consecutive patients undergoing any urological surgery with preoperative urine culture. The occurrence of a UTI or a surgical site infection within 30 days after the procedure served as the primary outcome. 

From 2016 to 2023, a total of 2,389 patients from 10 centres were included in the analysis. Of these, 838 (35 percent) had positive urine cultures (mono-/bi-/polymicrobial). Postoperative infections occurred in 106 patients (4.4 percent), of whom 44 had negative urine culture (41 percent), 42 had positive mono-/bimicrobial urine culture (40 percent), and 20 had polymicrobial urine culture (19 percent). 

Multivariate analysis revealed the following independent risk factors for postoperative febrile infections: UTI during the previous year of surgery (odds ratio [OR], 3.43, 95 percent confidence interval [CI], 2.07–5.66; p<0.001), mono-/bimicrobial preoperative urine culture (OR, 3.68, 95 percent CI, 1.57–8.42; p=0.002), polymicrobial preoperative urine culture (OR, 2.85, 95 percent CI, 1.52–5.14; p<0.001), and operative time (OR, 1.09, 95 percent CI, 1.04–1.15; p<0.001). 

“The effectiveness of systematic preventive antibiotic therapy for a positive urine culture has not been conclusively established,” the authors said.