Research progress of asymptomatic bacteriuria before arthroplasty: A systematic review

BACKGROUND: A high prevalence of asymptomatic bacteriuria exists in patients prior to arthroplasty, and urinary tract infection is considered to be a source of postoperative superficial wound and prosthetic joint infections. There is no consensus whether to screen for and treat asymptomatic bacteriuria before arthroplasty. OBJECTIVE: To summarize the association between asymptomatic bacteriuria and complications after arthroplasty and to evaluate the clinical benefits of treating asymptomatic bacteriuria prior to arthroplasty. METHOD: We systematically searched PubMed, Embase, and the Cochrane Library to retrieve potentially eligible articles. By screening the titles and abstracts of retrieved records and then reading the full texts of the remaining papers, we finally included 8 English-language articles in this systematic review. RESULTS: Asymptomatic bacteriuria prior to arthroplasty is significantly associated with an increased occurrence of postoperative prosthetic joint and superficial wound infections. However, there is little evidence for direct or hematogenous seeding of urinary infections, and treating asymptomatic bacteriuria before arthroplasty did not decrease the incidence of postoperative infectious complications. CONCLUSION: Asymptomatic bacteriuria is not a contraindication for arthroplasty, and the practice of routine preoperative screening for and treatment of asymptomatic bacteriuria should not be continued.