Routine preoperative urine screening offers no clinical benefit, according to a large study published Dec. 12 in JAMA Surgery. Treating asymptomatic bacteriuria detected by screening does not cut the risk for postoperative infections, including UTI and SSI, the authors say. “This study is the largest and most robust investigation into urine culture screening to date,” write the authors led by Jaime Gallegos Salazar, M.D., from the VA Boston Healthcare System in Massachusetts. “It provides strong evidence that preoperative screening may not be valuable and should be discontinued as routine clinical practice.” Given concerns about antibiotic stewardship, the Choosing Wisely campaign recommends not treating asymptomatic bacteriuria (ASB) in most circumstances. However, surgeons installing new hardware often feel compelled to treat any colonizing organism in the hopes of preventing dangerous postoperative infections, such as prosthetic joint infections. More recently, the Infectious Diseases Society of America’s 2018 AMB guidelines also recommend against preoperative screening, but lacked high-quality, supporting data. The Veterans Affairs (VA) researchers used data from 68,265 U.S. veterans (96.2 percent men; mean age, 64.6 years) who underwent cardiac, orthopedic, or vascular surgical procedures at 109 U.S. Department of Veterans Affairs health care system facilities (Oct. 1, 2008, to Sept. 30, 2013). […]