MP54-08 INCIDENCE AND RISK FACTORS FOR POSITIVE URINE CULTURE AT THE TIME OF PEDIATRIC UROLOGIC SURGERY

Abstract

You have accessJournal of UrologyPediatrics: Urinary Tract Infections/Vesicoureteral Reflux1 Apr 2015MP54-08 INCIDENCE AND RISK FACTORS FOR POSITIVE URINE CULTURE AT THE TIME OF PEDIATRIC UROLOGIC SURGERY Michael A Maccini, David Chalmers, and Jeffrey B. Campbell Michael A MacciniMichael A Maccini More articles by this author , David ChalmersDavid Chalmers More articles by this author , and Jeffrey B. CampbellJeffrey B. Campbell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2031AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary tract infections (UTI) are common in pediatric urology populations. Unrecognized bacteriuria at the time of urologic surgery may put patients at risk for complications. Many providers obtain preoperative and/or intraoperative urine cultures when performing surgery on the urinary tract, but there are no data in the literature documenting the overall rate of positive urine culture at the time of pediatric urologic surgery. We hypothesized that there are risk factors associated with an increased likelihood of positive urine culture at the time of pediatric urologic surgery. METHODS We identified all patients less than 18 years of age undergoing endoscopic urologic procedure or surgery on the collecting system from 01/01/08 through 12/31/13 with a single pediatric urologist (JBC) who routinely sends intraoperative urine cultures. We performed a retrospective chart review, collecting demographic information, intraoperative urine culture results (defined as positive if >100,000 or 10-100,000 CFU of a single pathogenic organism), circumcision status, and suspected risk factors from problem/diagnosis lists (hydronephrosis, vesicoureteral reflux, UPJ obstruction, urolithiasis, neurogenic bladder, posterior urethral valves, ureterocele, and constipation). We also examined all prior urine culture results in our electronic medical record. We then analyzed each item for relative risk of positive urine culture at the time of surgery. RESULTS A total of 838 procedure records (470 unique patients) were reviewed. 717 had associated intraoperative urine culture results (85.6%) and were further analyzed. Overall, 97 (13.5%) cultures were positive. Factors associated with increased relative risk included neurogenic bladder (p<0.0001), prior UTI (p<0.0001), constipation (p<0.0001), female gender, (p=0.001), and urolithiasis (p<0.05). The absence of any of the selected diagnoses was associated with a reduced risk of positive culture (p<0.05). CONCLUSIONS Patients with neurogenic bladder, prior UTI, constipation, female gender, and urolithiasis have an increased likelihood of bacteriuria at the time of pediatric urologic surgery. This information may be helpful in tailoring the acquisition of preoperative and/or intraoperative urine cultures, which may result in significant cost savings. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e667-e668 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael A Maccini More articles by this author David Chalmers More articles by this author Jeffrey B. Campbell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...