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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Microbiota of the Urogenital Tract01:28

Microbiota of the Urogenital Tract

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The human urogenital system, once thought to be sterile in healthy individuals, is now recognized as a complex microbial habitat. Advancements in molecular sequencing techniques have revealed that even in healthy adults, the kidneys and bladder harbor microbial populations similar to those found in the distal urethra, albeit in much lower abundance. These resident microorganisms, while generally innocuous, can become opportunistic pathogens under conditions that alter the urogenital...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Updated: Mar 24, 2026

Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
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Asymptomatic Bacteriuria and Periprosthetic Joint Infection Risk: A Systematic Review and Meta-Analysis.

V Roy1, A Van Brenk2, L R Benaroch1

  • 1Schulich School of Medicine & Dentistry, Department of Orthopaedic Surgery, University of Western Ontario, London, Canada.

The Journal of Arthroplasty
|March 22, 2026
PubMed
Summary
This summary is machine-generated.

Asymptomatic bacteriuria (ASB) shows a modest increased risk for periprosthetic joint infection (PJI) after undifferentiated arthroplasty. However, ASB does not appear to increase PJI risk for specific procedures like hip or knee arthroplasty.

Keywords:
asymptomatic bacteriuriaasymptomatic leukocyturiaperiprosthetic joint infectiontotal hip arthroplastytotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Public Health

Background:

  • Periprosthetic joint infection (PJI) is a significant complication following hip and knee arthroplasty.
  • The role of asymptomatic bacteriuria (ASB) in causing PJI is not well-established.

Purpose of the Study:

  • To systematically review and meta-analyze the association between asymptomatic bacteriuria and periprosthetic joint infection risk.

Main Methods:

  • A systematic search identified 16 studies (14 cohort, 2 RCTs) including over 49,000 joints.
  • Meta-analyses assessed PJI rates in patients with ASB, with subgroup analyses by procedure type and culture isolates.
  • Random-effects models with specific adjustments were employed.

Main Results:

  • Asymptomatic bacteriuria was associated with a statistically significant, albeit modest, increased odds of PJI in pooled undifferentiated arthroplasty data (OR 2.41).
  • Subgroup analyses by follow-up and procedure type did not yield significant results.
  • Antibiotic treatment showed no benefit for elective arthroplasty, and ASB posed no increased risk in hip fracture hemiarthroplasty.

Conclusions:

  • The findings suggest a modest increased risk of PJI associated with ASB in general arthroplasty, but not consistently for specific procedures.
  • Prophylactic antibiotics for ASB did not demonstrate a protective effect against PJI.
  • Routine preoperative urinalysis is not supported for antimicrobial stewardship in arthroplasty patients.