Postoperative urinary tract infection after urogynecologic surgery: timing and uropathogens
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 wel...
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| Published in: | International Urogynecology Journal Vol. 31; no. 8; pp. 1621 - 1626 |
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| Main Authors: | , |
| Format: | Journal Article |
| Language: | English |
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Springer International Publishing
01-08-2020
Springer Nature B.V |
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| Abstract | 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. |
|---|---|
| AbstractList | 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.
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.
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.
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. INTRODUCTION AND HYPOTHESISAlthough 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. METHODSThis 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. RESULTSOne 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. CONCLUSIONSMore 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. 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. |
| Author | Jung, Carrie E. Brubaker, Linda |
| Author_xml | – sequence: 1 givenname: Carrie E. orcidid: 0000-0002-9043-5408 surname: Jung fullname: Jung, Carrie E. email: jung.carrie@gmail.com organization: Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of California, San Diego – sequence: 2 givenname: Linda surname: Brubaker fullname: Brubaker, Linda organization: Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of California, San Diego |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31359115$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1371/journal.pmed.1002184 10.1016/j.ajog.2004.03.088 10.1016/S0022-5347(02)80328-7 10.1002/nau.22680 10.1016/j.transproceed.2010.02.002 10.1016/j.juro.2012.11.167 10.1007/s00192-018-3767-3 10.1097/AOG.0000000000000024 10.1007/s00192-015-2861-z 10.1016/j.jhin.2016.01.012 10.1056/NEJM199309093291102 10.1007/s00192-012-1709-z 10.1111/j.1464-410X.2005.05630.x 10.1056/NEJMoa1111967 10.1056/NEJMoa070416 10.1056/NEJMoa0912658 10.1007/s00192-008-0696-6 10.1007/s00192-010-1137-x 10.1007/s00192-011-1429-9 10.1056/NEJM198208193070802 10.1016/j.ajog.2015.05.032 10.1086/427507 10.1056/NEJMoa1302186 10.14423/SMJ.0000000000000659 10.1016/j.juro.2016.12.093 |
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| Copyright | The International Urogynecological Association 2019 The International Urogynecological Association 2019. |
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Although postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no... Although postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no standardized postoperative time... Introduction and hypothesisAlthough postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no... INTRODUCTION AND HYPOTHESISAlthough postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no... |
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| SubjectTerms | Drug resistance E coli Gynecology Medicine Medicine & Public Health Original Article Surgery Urinary tract infections Urogenital system Urology |
| Title | Postoperative urinary tract infection after urogynecologic surgery: timing and uropathogens |
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