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

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

doi:10.1080/10790268.2018.1451237

Cited by 5 publications

(2 citation statements)

References 24 publications

(32 reference statements)

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“…The Spanish Society of Clinical Microbiology and Infectious Diseases only recommends screening and treating AB in neurogenic or incontinent patients, as well as those with indwelling urine catheters, prior to prosthetic spinal surgery to avoid Gram-negative surgical site infections [ 41 ]. However, a recent study did not find differences in terms of surgical site infection, readmission or symptomatic UTI [ 131 ]; therefore, no consensus exists in these particular cases.…”

Section: Asymptomatic Bacteriuriamentioning

confidence: 99%

Recurrent Urinary Tract Infections and Asymptomatic Bacteriuria in Adults

Hernández-Hernández

Padilla‐Fernández

Ortega-González

et al. 2021

Curr Bladder Dysfunct Rep

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Section: Asymptomatic Bacteriuriamentioning

confidence: 99%

Recurrent Urinary Tract Infections and Asymptomatic Bacteriuria in Adults

Hernández-Hernández

Padilla‐Fernández

Ortega-González

et al. 2021

Curr Bladder Dysfunct Rep

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“…9 Several studies of both cardiac surgery and spinal cord surgeries have found no association with preoperative bacteriuria and postoperative infections. 7,[10][11][12] Despite recommendations against screening for ASB in nonpregnant adults from the US Preventative Services Task Force, or prior to nonurologic operations by the Infectious Disease Society of America, this practice has persisted. 13 Cardiothoracic surgeries have had some of the highest screening rates for urine testing preoperatively.…”

mentioning

confidence: 99%

If you don’t test, they will not treat: Impact of stopping preoperative screening for asymptomatic bacteriuria

Winkler

Huang

Starr

et al. 2023

ASHE

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Objective: Screening for asymptomatic bacteriuria (ASB) is not recommended outside of patients undergoing invasive urological procedures and during pregnancy. Despite national guidelines recommending against screening for ASB, this practice is prevalent. We present outcomes from a quality-improvement intervention targeting patients undergoing cardiac artery bypass grafting surgery (CABG) at Massachusetts General Hospital, a tertiary-care hospital in Boston, Massachusetts, where preoperative testing checklists were modified to remove routine urinalysis and urine culture. This was a before-and-after intervention study. Methods: Prior to the intervention, screening for ASB was included in the preoperative check list for all patients undergoing CABG. We assessed the proportion of patients undergoing screening for ASB in the 6 months prior to and after the intervention. We estimated cost savings from averted laboratory analyses, and we evaluated changes in antibiotic prescriptions. We additionally examined the incidence of postoperative surgical-site infections (SSIs), central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs) and Clostridioides difficile infections (CDIs). Results: Comparing the pre- and postintervention periods, urinalyses decreased by 76.5% and urine cultures decreased by 87.0%, with an estimated cost savings of $8,090.38. There were 50% fewer antibiotic prescriptions for bacteriuria after the intervention. Conclusions: Removal of urinalysis and urine culture from preoperative checklists for cardiac surgery led to a statistically significant decrease in testing without an increase in SSIs, CLABSIs, CAUTIs, or CDI. Challenges identified included persistence of checklists in templated order sets in the electronic health record.

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