Is Presence of Bacteria in Preoperative Microscopic Urinalysis of the Patients Scheduled for Cardiac Surgery a Reason for Cancellation of Elective Operation?

Abstract

BackgroundIn some hospitals, urinalysis is done routinely for all patients scheduled for cardiac surgery. Occasionally pyuria or bacteria is reported in the microscopic urinalysis of these patients that are clinically asymptomatic for urinary tract infections.ObjectivesWe were seeking answer to this question: is the presence of a different number of bacteria in preoperative microscopic urinalysis of asymptomatic patients scheduled for cardiac surgery indicative of potential postoperative complications and as a result, a good reason to postpone the operation?Patients and MethodsWe conducted a retrospective cross-sectional study based on the review of the medical records of 1165 patients who underwent open-heart surgery.ResultsOne hundered and fifty one patients were eligible in our established criteria. There were no significant difference between their demographic characteristics and the same number of randomly selected patients with normal urinalysis who had underwent open-heart surgery. In the bacteriuria group, two patients, and in the control group, three patients had an infection at the operation sites in the post-operative period, which was not a significant finding between two groups (P = 0.503).ConclusionsWe recommend that in the absence of symptoms of urinary tract infection, urinalysis is not necessary and not cost beneficial in the preoperative evaluation of patients scheduled for open-heart surgery.

Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI

“…However, preoperative antibiotic treatment did not show benefit, so postponing surgery or even treating patients with known ABU before surgery cannot be recommended [ 15 ]. Moreover, in the case of open-heart surgery, some authors stated that in the absence of symptoms of urinary tract infection, urinalysis or urine culture are not necessary and not cost beneficial in the preoperative evaluation of patients scheduled for open-heart surgery [ 16 ]. Furthermore, even if the ABU is frequent among kidney transplant patients during the first year post transplantation, recent evidence showed no benefit for the antibiotic treatment of ABU in the short- and long-term follow-ups [ 17 ].…”

Lower Respiratory Tract and Urinary System Colonization in Patients with Cardiovascular Surgery

“…Bunlardan birincisi Soltanzadeh ve ark. [1] savunduğu ekstrakorporeal dolaşımın vücudun bağışıklık sistemini baskıladığından hareketle asemptomatik kolonizasyonların aktif infeksiyona dönüşebileceği olasığıdır. Bu yazarlara göre bakterilerin hematojen yayılımı ürosepsis, sepsis, mediastinit ve eğer kapak vb.…”

“…yerleşimi kolaylaştırıcı yabancı bir materyal kullanıldıysa endokardite neden olabilirler. Bu nedenle benzer düşünen yazarlar kolonizasyonların preoperatuvar dönemde tedavi edilmesini öneririler [1,[16][17][18][19] . Bunun karşıt teorisi ise Darouiche ve ark.…”

“…Açık kalp cerrahisi kardiyopulmoner baypas dolaşımı kullanımı nedeniyle ameliyat sırasında ve sonrasında yaşamsal organlarda yaygın patofizyolojik değişikliklere neden olan en önemli operasyonlardan biridir. Perioperatif dönemde fizyolojik, mekanik ve biyokimyasal büyük boyuttaki değişiklikler anesteziyolog ve kalp cerrahından oluşan cerrahi ekibin ameliyat öncesi kapsamlı bir değerlendirme yapmasını gerektirir [1] .…”

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

“…10 Other retrospective and prospective cohort studies have not found pre-op ASB to be a significant risk factor for post-op infection in patients undergoing orthopedic, cardiothoracic, and vascular surgery and have not demonstrated clear benefits from pre-op ASB screening and treatment. [11][12][13][14] To our knowledge, no studies have examined the association between ASB and post-op infection in patients with SCI or other disorders associated with neurogenic bladder. In our clinical experience, neurogenic bladder and use of urinary catheters often motivates providers to screen patients for ASB prior to non-urologic surgery.…”