Urinary Infection and Colonization in Bone Procedures

Condition(s) studied

Study summary

For seniors aged 65 and over (inclusive) undergoing surgical procedures (bone surgery, traumatology, orthopedics) in an acute or elective setting, the relationship between preoperative urinary tract infection/colonization (within 30 days before the procedure) and the occurrence of predefined postoperative complications (monitoring during the patients' hospitalization) will be observed

Eligibility

Primary outcome measure(s)

• Urinary tract infection preoperatively - signs and symptoms — one week before surgery
  Signs and symptoms include dysuria, frequency, urgency, or/and fever or/and smelling urine and non-specific signs (nausea, malaise)
• Urinary tract infection preoperatively - urinary dipstick test. — one week before surgery
  Positive urine dipstict test (i.e. nitrate-reductace and leukocyte esterase detection).
• Urinary tract infection preoperatively - chemical examination of the urine and sediment - pH — one week before surgery
  Positive result in chemical examination of the urine and the sediment for the possibility of infection s: pH ≥ 6.
• Urinary tract infection preoperatively: chemical examination - proteinuria (urine dipstick test) — one week before surgery
  Detection of proteinuria with urine dipstick test.
• Urinary tract infection preoperatively - leukocytouria (urine dipstick test) — one week before surgery
  Positive result t is leukocyturia (detection of leucocyte esteras) in a dipstick test.
• Urinary tract infection preoperatively chemical examination of the urine and sediment -pyuria (urine dipstick test) — one week before surgery
  Pyuria, which is the presence of white blood cells in the urine, will detected through these methods: Postive urine dipstick test - showing leukocyte esterase or nitrites. And additionally have to present: discoloration, clouding or change in the smell of urine for a pyuria
• Urinary tract infection preoperatively: chemical examination of the urine and sediment -bacteriuria (urine dipstick test) — one week before surgery
  Presence of bacteriuria (presence of bacteria in the urine). Can be detected through urine dipstick test (determination of presence of leukocyte esterase and nitrites, which are indicators of white blood cells and bacteria in the urine)
• Urinary tract infection preoperatively - chemical examination preoperatively - chemical examination of the urine and sediment -bacteriuria — one week before surgery
  Presence of bacteriuria (presence of bacteria in the urine). Can be detected through through flow cytometry (this method detects bacteria in urinary samples in the range from 40 up to 1000/μl),
• Urinary tract infection preoperatively: chemical examination of the urine and sediment -bacteriuria (urine culture) — one week before surgery
  Presence of bacteriuria (presence of bacteria in the urine). Can be detected through urine culture (bacteria grow from a urine sample, cutoff is for a significant bacterial count is typically greater than 100,000 colony-forming units (CFU) per mililiter).
• Urinary tract infection preoperatively - chemical examination preoperatively - chemical examination of the urine and sediment - proteinuria — one week before surgery
  Detection of proteinuria with the sulfosalicylic acid test in laboratory. A semiquantitative scale is used for evaluation: 1. Opalescence - approximate concentration of protein in g/l: 0,05-0,1 2. Slight turbidity (transparent, underlying text can be read - approximate concentration of protein in g/l: 0,1-0,2 3. Milky turbidity (opaque, without flakes) - approximate concentration of protein in g/l: 0,5-1,0 4. Milky turbidity with flake formation: approximate concentration of protein in g/l: 2,0-5,0 5. Flocculent precipitate: approximate concentration of protein in g/l ≥ 5,0
• Urinary tract infection preoperatively - leukocytouria (sediment) — one week before surgery
  Positive result is finding in the in sediment more than 10 leukocytes per field of view.
• Urinary tract infection preoperatively chemical examination of the urine and sediment -pyuria (microscopy) — one week before surgery
  Pyuria, which is the presence of white blood cells in the urine, will detected through these methods: Microscopy - cell counts performer by microscopy, positive finding is more than 10 leukocytes per field of view. And additionally have to present: discoloration, clouding or change in the smell of urine for a pyuria.
• Urinary tract colonization preoperatively - asymptomatic bacteriuria, women (urine culture) — one week before surgery
  Midstream clean catch urine specimen will be needed. Two consecutive specimens with isolation of the same bacteria species with at least 100,000 colony-forming units (CFUs) per ml of urine.
• Urinary tract colonization preoperatively - asymptomatic bacteriuria, men (urine culture) — one week before surgery
  Midstream clean catch urine specimen will be needed. For men, a single specimen with isolation of one bacteria species with at least 100,000 CFUs per ml of urine.
• Urinary tract colonization preoperatively - asymptomatic bacteriuria, catheterized specimen (urine culture)) — one week before surgery
  For women or men, a single specimen with isolation of one bacteria species with at least 100 CFUs per ml of urine.
• Antibiotic therapy before the surgery — one week before surgery
  Preoperative antibiotic use will be recorded. Options yes, no. If yes, the type of antibiotic used will be recorded.
• Postoperative complications - fever — one week after surgery
  Fever is defined as a body temperature above 38 degrees Celsius
• Postoperative complications -circulatory instability — one week after surgery
  Presence of hypotension, MAP below 70 mm Hg
• Postoperative complications -I nfection — one week after surgery
  Presence of infection and origin of the infection in laboratory findings and in clinical picture.
• Postoperative complications - sepsis — one week after surgery
  Presence of sepsis and origin of the infection in laboratory findings and in clinical picture.
• Postoperative complications -postoperative delirum — one week after surgery
  Presence of postoperative delirium. To determine the diagnose CAM-ICU will be used.
• Postoperative complications - antibiotic — one week after surgery
  Administered antibiotic treatment and its duration

Trial sites (1)

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