Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database

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发表日期：

2024年3月20日

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Elias Ayoub,
Stessy Kutchukian,
Pierre Bigot,
Aurélien Dinh,
Bastien Gondran-Tellier,
Humphrey Robin,
Marc Françot,
Stéphane de Vergie,
Jérôme Rigaud,
Mathilde Chapuis,
Laurent Brureau,
Camille Jousseaume,
Omar Karray,
Fares T. Kosseifi,
Shahed Borojeni,
Aurélien Descazeaud,
Harrison-Junior Asare,
Maxime Gaullier,
Baptiste Poussot,
Thibault Tricard,
Michael Baboudjian,
Éric Lechevallier,
Pierre-Olivier Delpech,
Héloïse Ducousso,
Simon Bernardeau,
Franck Bruyère,
Maxime Vallée

摘要

Introduction

In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence. Our main end point in this study is to analyze the relationship between preoperative urine culture and the risk of postoperative febrile urinary tract infection (UTI) or surgical-site infection (SSI) in partial or radical nephrectomy patients.

Methods

We conducted a multicenter retrospective cohort study between January 2016 and January 2023 in 11 French tertiary referral hospitals (TOCUS database). We collected the data for 269 patients including several pre-, intra-, and post-operative variables that could potentially increase the risk of postoperative UTI and SSI including preoperative urinary culture results.

Results

The incidence rate of postoperative UTI and SSI was 8.9% in our study. After conducting a logistic multivariate analysis, a propensity score matching analysis, and a subgroup analysis, we found no significant correlation between the urine culture and the postoperative UTI risk [OR = 1.2 (0.5–2.7) (p = 0.7)]. Only the postoperative non-infectious complications were related to a higher risk of postoperative UTI [OR = 12 (4–37), p < 0.001)].

Conclusion

Our research shows that screening and treating for ABU prior to radical or partial nephrectomy seems to be unnecessary to prevent postoperative UTI and SSI.