Introduction and Objectives: The medical literature describes asymptomatic urinary tract infections (UTI) in up to 30% of postmenopausal women. Our aim was to analyze the prevalence of asymptomatic UTI in patients waiting to undergo programmed hip/knee arthroplasty and also the risk of dissemination of the infection through the blood stream.

Materials and Methods: We included 200 patients that had undergone hip/knee arthroplasties in our study (15.1.07–22.10.07). 69.97+/−10.28 years of age, 130 women/70 men. Urine and sediment analysis on entry (12 hours before surgery). Abnormal values: density< 1.006/> 1.030; pH< 4.6/> 7.0; leucocytes and/or positive nitrites; sediment with bacteriuria, piuria and/or > 5 leucocytes/field. If the urine or sediment analysis gave abnormal values: Preoperative quantitative urine culture. If < 10.000 CFUs/ml, no UTI; > 10.000 but < 100.000 urine culture is repeated; > 100.000 CFUs, diagnosis of UTI, specific antibiotics orally for 7 days during the postoperative period. None of the patients underwent urethra catheterization. All received cefazoline 1g i.v/8 hours for 48 hours postoperatively.

Results: Loss to follow-up: 0 patients. If the urine or sediment analysis gave abnormal values: 82/200 patients of 72.59+/−7.32 years of age, 72 women/10 men. In 11/82 patients: no valid uroculture. In 8/82 patients (8/200, 4% of the total series): Pathological urine culture, 4 E. coli, 1 P. aeruginosa, 1 P. putida, 1 K. oxytoca, 1 K. pneumoniae. Treatment: quinolones/amoxicillin-clavulanic acid (not carried out in 3 cases). Up to the now there are no signs of infection in the arthroplasties.

Discussion and Conclusions:

Patients undergoing programmed hip/knee arthroplasties frequently have abnormal preoperative urine analysis.

Introduction: There are descriptions in the medical literature of asymptomatic bacteriurias in 30% of post-menopausal women.

Purpose: To analyze the prevalence of asymptomatic bacteriuria and the risk of blood-route dissemination in patients undergoing elective hip arthroplasty.

Patients and Methods: All asymptomatic patients undergoing surgical hip arthroplasty between January 15, 2007 and March 30, 2007 were included. There was a total of 45 patients of 65.9 +/−12.9 (range: 33–85) years of age, out of which 23 (51.1%) were male. A urine test was administered on admission (12 hours before surgery). Normal analysis: density< 1.006/> 1.030; pH< 4.6/> 7.0; leucocytes and/or positive nitrites; sediment with bacteriuria, piouria and/or > 5 leucocytes/field. If the urine analysis was abnormal, a preoperative quantitative uroculture was carried out. If < 10000 CFUs/ml, no UTI (urinary tract infection); if > 10000 but < 100000, a new urine culture was performed; if > 100000 CFUs, diagnosis of UTI, specific oral antibiotics were administered for 7 days postoperatively. None of the patients underwent urethra catheterization. All received cefazoline 1g i.v/8 hours for 48 hours postoperatively.

Results: Loss to follow-up: 0 patients. Normal analysis: 12/45(26.7%) patients of 73.8+/−8.5 (55–85) years of age, 12 females (100.0%). In 1 of these 12 patients (8.3%) (1/45 or 2.2% of the total series) the urine culture was positive for Pseudomona aeruginosa. Up to the current time none of these 45 patients has developed signs of infection in their arthroplasty.

Conclusions:

(1) Women undergoing elective hip arthroplasty frequently have abnormal preoperative urine analysis.