Screening Patients Undergoing Total Hip or Knee Arthroplasty with Perioperative Urinalysis and the Effect of a Practice Change on Antimicrobial Use
| العنوان: | Screening Patients Undergoing Total Hip or Knee Arthroplasty with Perioperative Urinalysis and the Effect of a Practice Change on Antimicrobial Use |
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| المؤلفون: | Nicolas O. Noiseux, Ambar Haleem, Jean M. Pottinger, Samuel Bailin, Loreen A. Herwaldt, Sarah J Johnson, Birgir Johannsson |
| المصدر: | Infection control and hospital epidemiology. 38(3) |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Microbiology (medical), Male, medicine.medical_specialty, Urinalysis, Epidemiology, medicine.medical_treatment, Urinary system, Arthroplasty, Replacement, Hip, 030232 urology & nephrology, Urine, 03 medical and health sciences, Leukocyte Count, 0302 clinical medicine, Anti-Infective Agents, medicine, Humans, Surgical Wound Infection, Prospective Studies, Prospective cohort study, Arthroplasty, Replacement, Knee, Perioperative Period, Aged, Retrospective Studies, 030222 orthopedics, medicine.diagnostic_test, business.industry, Retrospective cohort study, Perioperative, Middle Aged, Arthroplasty, Iowa, Surgery, Leukocyte esterase, Infectious Diseases, Logistic Models, Orthopedic surgery, Urinary Tract Infections, Female, business, Carboxylic Ester Hydrolases |
| الوصف: | OBJECTIVETo identify predictors of treatment for urinary tract infections (UTI) among patients undergoing total hip (THA) or knee (TKA) arthroplasties and to assess an intervention based on these predictors.DESIGNWe conducted a retrospective cohort study of 200 consecutive patients undergoing THA/TKA between February 21, 2011, and June 30, 2011, to identify predictors of treatment for UTI and a prospective cohort study of 50 patients undergoing these procedures between May 21, 2012, and July 17, 2012, to assess the association of signs or symptoms and UTI treatment. We then conducted a before-and-after study to assess whether implementing an intervention affected the frequency of treatment for UTI before or after THA/TKA.SETTINGThe orthopedics department of a university health center.PATIENTSPatients undergoing THA or TKA.INTERVENTIONSurgeons revised their UTI screening and treatment practices.RESULTSPositive leukocyte esterase (PP5 (P=.01;P=.01) were associated with preoperative or postoperative UTI treatment. In the prospective study, 12 patients (24%) had signs and symptoms consistent with UTI. The number of patients treated for presumed UTI decreased 80.2% after the surgeons changed their practices, and surgical site infection (SSI) rates, including prosthetic joint infections (PJIs), did not increase.CONCLUSIONSUrine leukocyte esterase and white blood cell count were the strongest predictors of treatment for UTI before or after THA/TKA. The intervention was associated with a significant decrease in treatment for UTI, and SSI/PJI rates did not increase.Infect Control Hosp Epidemiol2017;38:281–286 |
| تدمد: | 1559-6834 0899-823X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::baf4560afe5ca9ae0c1915e8e8c2a02cTest https://pubmed.ncbi.nlm.nih.gov/27869063Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....baf4560afe5ca9ae0c1915e8e8c2a02c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15596834 0899823X |
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