Investigation of preoperative asymptomatic bacteriuria as a risk factor for postvertebroplasty infection

Kuan Jung Chen, Yen Chun Huang, Yu Cheng Yao, Tzu Cheng Yang, Hsi Hsien Lin, Shih Tien Wang, Ming Chau Chang, Po Hsin Chou*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Postvertebroplasty infection (PVI) is a catastrophic complication after vertebroplasty (VP). Although the urinary tract has been considered as a source of infectious pathogens, whether asymptomatic bacteriuria (ASB) is a risk factors for PVI remains unknown. Methods: This retrospective study included 716 patients (207 males; 509 females) treated with VP for osteoporotic vertebral fractures in a single medical center between May 2015 and December 2019. Clinical symptoms, urinalysis results, and culture data were collected preoperatively to identify patients with ASB. The primary outcome was PVI at the index level during follow-up. Demographic data and laboratory test results were compared between the PVI and non-PVI groups. Results: The mean age of the cohort was 78.6 ± 9.6 (range, 63-106). The prevalence of ASB was 14.1%, with female predominance (63.4%). The overall PVI rate was 1.26% (9/716). The PVI group had more patients with ASB (4/9, 44.4%) than did the non-PVI group (97/707, 13.7%) (p = 0.027). The rate of ASB treatment was similar between the PVI and non-PVI groups (25% vs. 23.7%, respectively). No case of PVI was caused by the urine culture pathogen. Multivariate analysis identified the following risk factors for PVI: ASB (odds ratio [OR], 5.61; 95% CI, 1.14-27.66; p = 0.034), smoking (OR, 16.26; 95% CI, 2.58-102.65; p = 0.003), and malignancy (OR 7.27; 95% CI, 1.31-40.31; p = 0.023). Conclusion: ASB was not uncommon among patients admitted for VP and should be considered a marker of relatively poor host immunity. Preoperative ASB, a history of malignancy, and smoking were identified as significant risk factors for PVI.

Original languageEnglish
Pages (from-to)233-239
Number of pages7
JournalJournal of the Chinese Medical Association
Volume86
Issue number2
DOIs
StatePublished - 1 Feb 2023

Keywords

  • Asymptomatic bacteriuria
  • Postvertebroplasty infection
  • Risk factor
  • Urinary tract infection
  • Vertebral fracture

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