Preoperative Urine Cultures at a Veterans Affairs Medical Center

T he value of preoperative urine screening is unproven, except before urologic procedures, in which detection and treatment of asymptomatic bacteriuria is beneficial. Despite this, authors of multiple small case series advocate for screening before nonurologic procedures. However, patients with detected bacteriuria may undergo further testing and, if prescribed antimicrobial drugs, can develop diarrhea, allergic reactions, and Clostridium difficile infection (CDI). In addition, treatment of bacteriuria can delay procedures and extend hospitalization. Accordingly, we reviewed the medical records of patients who underwent cardiothoracic, orthopedic, and vascular procedures to document (1) the frequency of preoperative culture (UC) use, (2) the frequency of consequent antimicrobial therapy, and (3) any effect of preoperative urine screening, or consequent antimicrobial therapy, on postoperative complications.