Bacteriuria and urinary tract infection after female urodynamic studies: Risk factors and microbiological analysis

• Published in: American journal of infection control 2015-10, Vol.43 (10), p.1035-1039
• Main Authors: Nóbrega, Mônica Martins, MD, Auge, Antonio Pedro Flores, MD, PhD, de Toledo, Luis Gustavo Morato, MD, PhD, da Silva Carramão, Sílvia, MD, PhD, Frade, Armando Brites, MD, PhD, Salles, Mauro José Costa, MD, MSc, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Bacteria - classification; Bacteria - isolation & purification; Bacterial Infections - epidemiology; Bacterial Infections - microbiology; Bacteriuria; Body mass index; Brazil; Diagnostic Techniques, Urological - adverse effects; Female; Gram-negative bacteria; Humans; Infection; Infection Control; Infectious Disease; Middle Aged; Multivariate analysis; Prospective Studies; Risk factor; Risk Factors; Urinary tract; Urinary tract diseases; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology; Urodynamic; Urodynamics; Women; Womens health
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2015.05.031

Background This study was conducted to determine risk factors for infectious complications after urodynamic study (UDS) in women, which can assist clinicians in identifying high-risk subjects who would benefit from antibiotic prophylaxis before UDS. Methods In this prospective cohort study, we studied 232 women who underwent UDS at Santa Casa de São Paulo School of Medical Sciences between June 2013 and June 2014. Women ranging in age from 26 to 84 years who had urinary incontinence, pelvic organ prolapse, or voiding dysfunction were required to collect urine samples at 7 days before, on the day of, and 3-5 days after UDS. Urine cultures with >100,000 CFU/mL were considered positive. Risk factors associated with bacteriuria and urinary tract infection (UTI) after UDS were evaluated using multivariate analysis with multiple logistic regression. Results Two hundred thirty-two out of 257 women were subjected to further analysis. The incidence of bacteriuria, transient bacteriuria, and UTI after UDS was 11.6%, 7.3%, and 4.3%, respectively. On multivariate analysis, hypothyroidism ( P  = .04), body mass index (BMI) >30 ( P  = .025), and advanced pelvic organ prolapse ( P  = .021) were associated with a significantly increased risk of bacteriuria; however, only BMI >30 ( P  = .02) was associated with an increased risk for UTI. Conclusions The rate of infectious complications after UDS was low, and advanced pelvic organ prolapse and hypothyroidism increased the risk for bacteriuria. However, only BMI >30 was associated with bacteriuria and UTI after UDS.