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Do Routine Preoperative and Intraoperative Urine Cultures Benefit Pediatric Vesicoureteral Reflux Surgery?

机译:常规术前和术中尿培养对小儿膀胱输尿管反流手术有好处吗?

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摘要

Objective. To determine if routine preoperative and intraoperative urine cultures (UCx) are necessary in pediatric vesicoureteral (VUR) reflux surgery by identifying their association with each other, preoperative symptoms, and surgical outcomes. Materials and Methods. A retrospective review of patients undergoing ureteral reimplant(s) for primary VUR at a tertiary academic medical center between years 2000 and 2014 was done. Preoperative UCx were defined as those within 30 days before surgery. A positive culture was defined as >50,000 colony forming units of a single organism. Results. A total of 185 patients were identified and 87/185 (47.0%) met inclusion criteria. Of those, 39/87 (45%) completed a preoperative UCx. Only 3/39 (8%) preoperative cultures returned positive, and all of those patients were preoperatively symptomatic. No preoperatively asymptomatic patients had positive preoperative cultures. Intraoperative cultures were obtained in 21/87 (24.1%) patients; all were negative. No associations were found between preoperative culture results and intraoperative cultures or between culture result and postoperative complications. Conclusions. In asymptomatic patients, no associations were found between the completion of a preoperative or intraoperative UCx and surgical outcomes, suggesting that not all patients may require preoperative screening. Children presenting with symptoms of urinary tract infection (UTI) prior to ureteral reimplantation may benefit from preoperative UCx.
机译:目的。为了确定小儿膀胱输尿管反流手术中是否需要常规术前和术中尿培养(UCx),方法是确定它们相互之间的关联,术前症状和手术结局。材料和方法。回顾性分析了2000年至2014年间在三级学术医学中心接受输尿管原发性VUR的患者。术前UCx定义为手术前30天内。阳性培养物定义为单一生物体的> 50,000个菌落形成单位。结果。总共鉴定出185例患者,其中87/185(47.0%)符合纳入标准。其中,39/87(45%)患者完成了术前UCx。术前仅有3/39(8%)的培养物恢复阳性,所有这些患者在术前都有症状。没有术前无症状的患者术前培养阳性。 21/87(24.1%)患者进行了术中培养。一切都是负面的。在术前培养结果与术中培养之间或培养结果与术后并发症之间未发现关联。结论。在无症状患者中,术前或术中UCx的完成与手术结局之间未发现关联,表明并非所有患者都需要术前筛查。在输尿管再植入之前出现尿路感染(UTI)症状的儿童可能会受益于术前UCx。

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