Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/21824
Title: Systematic review: bacterial colonisation of conduits and neobladders-when to test, watch, and treat.
Authors: Qu, Liang G;Adam, Ahmed;Ranasinghe, Weranja K B;Lawrentschuk, Nathan
Affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Division of Urology, University of the Witwatersrand, Johannesburg, South Africa
Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
University of Texas, MD Anderson Cancer Center, Houston, TX, USA
Issue Date: 27-Sep-2019
EDate: 2019-09-27
Citation: World journal of urology 2019; online first: 27 September
Abstract: Urinary diversion procedures frequently result in bacterial colonisation. There is an increased incidence of developing urinary tract infections (UTIs) in this patient population. Current guidelines, however, recommend against treating this colonisation. This systematic review aimed to determine when and how to test, monitor, and treat bacteriuria in patients with urinary diversion. A systematic search strategy was conducted based on keywords "urinary diversion" and "bacteriuria", on MEDLINE, Embase, and Google Scholar. Articles were screened and included only if they reported on (i) testing methods for bacteriuria, (ii) surveillance of bacteriuria over time, or (iii) when and how to treat bacteriuria. Results were summarised and reported using a narrative synthesis. Altogether, 26 studies were included in this review. Inconsistencies were noted in the definitions of bacteriuria, with most studies reporting bacteriuria as > 104 cfu/mL (8/17 studies). Bacteriuria prevalence varied greatly (range 9.1-100%). Monitoring bacteriuria over time may help detect a reduction in bacteriuria, as demonstrated in three studies (follow-up range 5-18 months; sample size 18-56). The link between preceding bacteriuria and subsequent UTIs has not been fully explored yet. Short-term antimicrobial therapy may be useful in the immediate post-operative setting; however, long-term prophylactic treatment is ineffective in preventing bacteriuria. We recommend consistent reporting of bacteriuria definitions, the benefits of monitoring bacteriuria over time, and use of short-term antimicrobial therapy; bacteriuria should not be treated with long-term therapy.
URI: http://ahro.austin.org.au/austinjspui/handle/1/21824
DOI: 10.1007/s00345-019-02964-8
ORCID: 0000-0002-5710-1983
0000-0001-8553-5618
0000-0002-4006-0388
PubMed URL: 31560122
Type: Journal Article
Review
Subjects: Bacterial colonisation
Bacteriuria
Surveillance
Urinary diversion
Appears in Collections:Journal articles

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