A Case-Control Study on the Association between Salmonella Bacteriuria and Cystoscopy

Area of Science:

• Infectious Diseases
• Urology
• Public Health Microbiology

Background:

• Urinary tract infections (UTIs) caused by Salmonella species are rare following cystoscopy.
• Existing disinfection protocols for cystoscopes may be insufficient to prevent Salmonella transmission.
• Limited data exists on the association between cystoscopy and Salmonella bacteriuria.

Purpose of the Study:

• To determine the association between cystoscopy and the development of Salmonella bacteriuria.
• To quantify the risk of Salmonella bacteriuria following cystoscopy.
• To inform public health investigations regarding cystoscope-associated infections.

Main Methods:

• Retrospective case-control study design.
• Inclusion of patients with Salmonella species in urine (cases) and blood (controls) from 2017-2019.
• Data collected from 16 hospitals in Eastern Ontario, Canada.

Main Results:

• Eight of eleven patients with Salmonella bacteriuria had undergone cystoscopy prior to infection.
• Three of seventy-four patients with Salmonella bacteremia had prior urological procedures, none being cystoscopy.
• A significantly high odds ratio (63.1) was observed for cystoscopy preceding Salmonella bacteriuria (p < 0.0001).
• Salmonella enteritidis was the most common isolate in bacteriuria cases.

Conclusions:

• Cystoscopy is identified as a significant risk factor for Salmonella bacteriuria.
• Findings suggest potential breaches in cystoscope disinfection procedures.
• Public health authorities should investigate the link between cystoscopy and Salmonella bacteriuria outbreaks.