I have seen numerous cases cancelled due to the discovery that a patient had a UTI. Many of these are asymptomatic, and are discovered simply by pre-op U/A and urine culture. I attempted to investigate the veracity of the claim that a pre-op UTI would increase the risk of a surgical site infection (SSI). I was unable to find anything neurosurgery specific. (I was tempted to put this topic in General Surgery, but I can imagine that some surgical procedures which are closer to the urinary system would have different risks. The likelihood of cutting the ureters, bladder or kidneys in a neurosurgical procedure is nearly zero, unless you're doing an anterior lumbar approach.)
I did find an article from the Ortho literature, dealing with joint infections and their association with either pre-op or post-op UTI. They analyzed over 19,700 records retrospectively, and found 58 wound infections (a suspiciously low rate of infection, in my opinion, but that's another story). They had 3 pre-op and 4 post-op UTI's, and only one patient had both a wound infection and a UTI from which the same organism was isolated. The other cases of simultaneous SSI/UTI grew different organisms from the wound culture than they grew from the urine culture.
Clin Orthop Relat Res. 2008 Nov 14.
Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty.
Koulouvaris P, Sculco P, Finerty E, Sculco T, Sharrock NE.They conclude:
Although limited, the data suggest patients with urinary tract infections had no more likelihood of postoperative infection. We believe treated urinary tract infection should not be a reason to delay or postpone surgery.
The article does refer to some other studies which showed such a relationship, but they are case reports or small case series. I was unable to find any significant studies demonstrating a significant relationship between perioperative UTI and SSI.
-- David
