Postoperative urinary tract infection after urogynecologic surgery: timing and uropathogens

• Published in: International Urogynecology Journal Vol. 31; no. 8; pp. 1621 - 1626
• Main Authors: Jung, Carrie E., Brubaker, Linda
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2020; Springer Nature B.V
• Subjects: Drug resistance; E coli; Gynecology; Medicine; Medicine & Public Health; Original Article; Surgery; Urinary tract infections; Urogenital system; Urology; Postoperative infection; Uropathogen; Urogynecologic surgery
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-019-04061-1

Introduction and hypothesis
Although postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no standardized postoperative time period used to assess this outcome, and the uropathogens unique to this sub-population of patients have not been well described. Our objective is to describe the timing and uropathogens of postoperative UTI after urogynecologic surgery.
Methods
This retrospective study analyzed postoperative UTI occurring within 90 days following urogynecologic procedures from November 2013 to January 2018 at a single academic institution. Postoperative UTI was defined as any uropathogen growth from standard urine culture. Continuous variables were compared with independent samples t-test and categorical variables with chi-square with Bonferonni corrections as appropriate.
Results
One hundred and two of 1085 (9.4%) patients experienced UTI; 63.7% occurred within 6 weeks and 78.4% within 8 weeks; 36.3% of UTIs occurred at a time period of 6 weeks to 90 days. Most commonly isolated uropathogens were
Escherichia coli
(47.8%) with an additional 11.2% extended-spectrum beta-lactamase (ESBL)
Escherichia coli
. Other bacteria included
Enterococcus faecalis
(10.4%),
Klebsiella pneumoniae
(9%), and one culture each for ESBL
Klebsiella pneumoniae
and vancomycin-resistant (VRE)
Enterococcus faecium.
Conclusions
More than one third of UTIs after urogynecologic surgery occur between 6 weeks and 90 days postoperatively. A plateau of UTI incidence occurs at 8 weeks, a time period at which 78.4% of all UTIs were captured.
Escherichia coli
was the most commonly isolated uropathogen, and multi-drug-resistant bacteria were implicated in 12.8% of UTIs.