关节置换围术期无症状性菌尿应用抗生素治疗必要性的Meta分析.

BACKGROUND: Periprosthetic joint infection is a serious and catastrophic complication after joint arthroplasty. For asymptomatic bacteriuria, during perioperative period of joint arthroplasty, many doctors choose oral antibiotics. However, the previous research on whether asymptomatic bacteriuria will cause periprosthetic joint infection has no consensus, and the effect of antibiotics is unknown. OBJECTIVE: To investigate whether asymptomatic bacteriuria is a risk factor for periprosthetic joint infection and whether antibiotic treatment is effective by meta-analysis. METHODS: Through systematic research based on computer of major foreign and Chinese databases, such as PubMed, Ovid, Cochrane Library, EMBASE, CNKI, WanFang, VIP, and CMB databases, and manual research, literature traceability was performed. The articles concerning the effect of asymptomatic bacteriuria on the prognosis of joint arthroplasty published before May 2018 was searched. Literature screening, quality evaluation and data extraction were performed according to the Cochrane system, and analysis was undergone on Review Manager 5.3 software. RESULTS AND CONCLUSION: (1) Nine articles were enrolled, involving 29 844 cases of joint arthroplasty, including 2 366 cases of asymptomatic bacteriuria. (2) Periprosthetic joint infection had a significantly higher incidence in the asymptomatic bacteriuria group than that in the non-asymptomatic bacteriuria group (OR=3.15, 95%CI: 1.23-8.02, P=0.02). (3) Seven in the nine articles reported the use of antibiotics for treating perioperative asymptomatic bacteriuria, and there was no significant difference in the incidence of periprosthetic joint infection between two groups (OR=1.64, 95%CI: 0.84-3.23, P=0.15). (4) To conclude, the occurrence of asymptomatic bacteriuria in the perioperative period of joint arthroplasty is a risk factor for periprosthetic joint infection, and the use of antibiotics for asymptomatic bacteriuria does not change the incidence of periprosthetic joint infection. [ABSTRACT FROM AUTHOR]