480 asymptomatic patients (370 hip arthroplasties; 297 females; median age 71 y) were enrolled. On admission, 171 patients (35%) had bacterial UTC, mostly due to E. coli. Urine analysis revealed also 169 episodes of leukocyturia. Almost all (95%) received a single-dose perioperative prophylaxis of cefuroxime 1.5 g IV. Median duration of postoperative urinary catheter carriage was 0 days (range, 0-13).
On postoperative day 3, urinary analysis was abnormal in 90 episodes of leukocyturia and 198 episodes of UTC, respectively. Day 3 -bacterial UTC was different from preoperative sampling among 50% of patients and microbiological results revealed a higher proportion of Gram-positive organisms.
Only 30 patients (6%) developed a symptomatic urinary tract infection during a follow-up of 3 months; one-third of pathogens were unrelated to those found during hospitalization. All symptomatic infections were treated with oral antibiotics. There was no seeding of joint prostheses. Estimated minimal laboratory costs for preoperative urinary analyses were € 27,300.