The relationship between asymptomatic bacteriuria and surgical site infection in hip fracture patients: a systematic review and meta-analysis.
Rohit Ravindran Nair, Emadeldin Mohamed Abbaker Ahmed, Kai Fung Kevin Suen et al.
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In 30 seconds
This systematic review and meta-analysis examined the relationship between peri-operative asymptomatic bacteriuria (ASB), its treatment, and surgical site infection (SSI) in hip fracture patients. Three studies involving 247 patients were included. Across studies reporting patients with ASB whether treated or untreated, the estimated SSI rate was 7.3% (95% confidence interval [CI]: 2.0-23.5%). Estimated rates were 13.0% (95% CI: 8.1-20.3%) in studies where ASB was treated and 4.4% (95% CI: 1.7-11.2%) where it was not treated; the groups were not formally compared.
Key findings
- Across three studies, the estimated SSI rate among patients with ASB, treated or untreated, was 7.3% (95% CI: 2.0-23.5%).
- In two studies reporting treated ASB, the estimated SSI rate was 13.0% (95% CI: 8.1-20.3%).
- In two studies reporting untreated ASB, the estimated SSI rate was 4.4% (95% CI: 1.7-11.2%); no formal group comparison was performed.
Why it matters
SSI can have serious consequences in hip fracture patients, yet this review found little high-quality evidence to clarify whether ASB is related to SSI or whether treating ASB reduces risk. The differing estimates across treated and untreated studies should not be interpreted as evidence that treatment increases infection, because the groups were not formally compared.
What to keep in mind
Only three studies and 247 patients were included. The small evidence base prevented formal comparison of SSI rates between treated and untreated ASB groups.