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01.08.2018 | Original Article

Impact of positive preoperative urine cultures before pediatric lower urinary tract reconstructive surgery

verfasst von: Alexander C. Small, Alejandra Perez, Jayant Radhakrishnan, Stanley Desire, Philip Zachariah, Lisa C. Creelman, Shumyle Alam

Erschienen in: Pediatric Surgery International | Ausgabe 9/2018

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Abstract

Purpose

Children who undergo lower urinary tract reconstruction (LUTR) often have asymptomatic bacteriuria or recurrent urinary tract infections (UTI). We aimed to determine the prevalence of positive preoperative urine cultures (PPUC) before LUTR and to analyze any impact on postoperative outcomes.

Methods

This retrospective review included all pediatric LUTR procedures utilizing bowel segments performed by one surgeon over 2 years. Preoperative cultures were obtained 1–2 days before surgery. Baseline characteristics and 90-day infection/readmission rates between patients with and without PPUC were compared using descriptive statistics, Fisher’s exact, and Mann–Whitney tests with significance p < 0.05.

Results

54 patients with mean age 10.1 ± 5.6 years underwent LUTR procedures using bowel including continent catheterizable channel (85%), enterocystoplasty (81%), and/or urinary diversion (9%). PPUC was present in 28 patients (52%). Postoperatively, 20% had inpatient infections, including eight UTI, four surgical site infections, and two bloodstream infections with no difference between those with or without PPUC. Within 90 days of discharge, 28% of patients were readmitted to the hospital, and there was no difference between groups. Postoperative urine cultures were positive in 83% of patients within 90 days.

Conclusions

Half of the patients undergoing LUTR have PPUC, but it does not increase the risk of postoperative infections or hospital readmissions. We believe complex LUTR can be safely performed in patients with PPUC.

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Titel: Impact of positive preoperative urine cultures before pediatric lower urinary tract reconstructive surgery
verfasst von: Alexander C. Small
Alejandra Perez
Jayant Radhakrishnan
Stanley Desire
Philip Zachariah
Lisa C. Creelman
Shumyle Alam
Publikationsdatum: 01.08.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 9/2018
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-018-4306-5

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Impact of positive preoperative urine cultures before pediatric lower urinary tract reconstructive surgery