在诊断性囊镜检查之前,应该进行尿液培养吗? 对手术后感染风险的影响
Alexandre Falkenrodt1, Ali Bourgi1, Franck Bruyère1
1Service d'Urologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France.
Surgical infections
|October 17, 2025
概括
在囊囊镜检查前进行常规的尿细菌培养是不必要的. 无症状的细菌尿不增加手术后尿路感染 (UTI) 的风险,可能减少诊断延迟和抗生素使用.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 医学诊断 医学诊断 医学诊断
背景情况:
- 尿路感染 (UTI) 是诊断囊镜的不常见并发症,发生在不到5%的病例中.
- 目前的指导方针缺乏关于尿囊镜前尿细菌培养 (UBC) 的必要性的明确性.
- 无症状细菌尿是尿液中细菌的存在,没有相关症状.
研究的目的:
- 为了确定在囊镜之前无症状的细菌尿是否会增加手术后尿路感染的风险.
- 为了确定患者相关的风险因素,后囊镜检查后的尿路感染.
- 评估是否需要进行例行前囊镜检查UBC.
主要方法:
- 在15天内对618名接受诊断性囊镜检查的患者进行了回顾性分析.
- 排除标准包括抗生素治疗或缺乏UBC结果.
- 囊镜术后的尿路感染被通过电话采访在四周内评估,使用CDC标准.
主要成果:
- 整体尿路感染率为4.7% (29例).
- 没有发现无症状细菌尿症和囊镜后尿道感染之间有显著的关联 (OR:1.385,p=0.52).
- 尿路感染风险增加与怀疑瘤的囊镜 (OR:4.981,p=0.035) 和尿路保留 (OR:7.910,p=0.023) 相关. 年龄是一个保护因素 (p=0.01).
结论:
- 在囊泡镜检查前无症状的细菌性尿症与随后发生尿路感染的风险增加无关.
- 在诊断囊镜之前进行常规UBC可能是不必要的.
- 停止常规UBC可以防止诊断延迟,减少抗生素消费,并对抗抗生素耐药性.
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