Asymptomatic urinary tract colonisation predisposes to superficial wound infection in elective orthopaedic surgery.

There is no evidence surrounding the benefits, effects or clinical outcomes treating asymptomatic urinary tract colonisation. A series of 558 patients undergoing elective admission for orthopaedic surgery were recruited prior to surgery and were screened for urinary tract infection (UTI). Patients had their urine dipstick tested and positive samples were sent for culture and microscopy. Patients with a positive urine culture were treated with antibiotics prior to surgery; 85% of dipsticks tested were positive, while only 7% of the urine samples were culture positive. Over 36% of patients with a pre-operative UTI show some form of post-operative delayed wound healing or confirmed infection versus 16% in the other subgroup giving a relative risk of wound complications of 2:1 (p < 0.02). We have established that patients who present to pre-admission with urinary tract colonisation are a high risk subgroup for wound infection post-operatively.