Preoperative urine culture with contaminants is not associated with increased risk for urinary tract infection after ureteroscopic stone treatment.

PURPOSE: We aimed to assess whether the presence of contaminants in the pre-operative urine culture (preop-UC) predicts postoperative urinary tract infection (postop-UTI) in patients undergoing elective ureteroscopy with laser lithotripsy. METHODS: A retrospective chart review was performed from 01/2019 to 12/2021 examining patients with unilateral stone burden ≤ 2 cm who underwent ureteroscopy with laser lithotripsy and had a preop-UC within 3 months. Positive, negative, contaminated, and polymicrobial definitions for UCs were established in accordance with current guidelines. Patients with positive and polymicrobial cultures were excluded. Postop-UTI was defined as the presence of urinary symptoms and a positive UC within 30 days of the procedure. Multivariable logistic regression models were utilized to evaluate risk factors for contamination in the preop-UC and the risk of postop-UTI. RESULTS: A total of 201 patients met the inclusion-exclusion criteria. Preop-UC was negative in 153 patients and contaminated in 48 patients. Significant contaminant-related factors included female gender and increased BMI. Postop-UTI was diagnosed in 3.2% of patients with negative preop-UCs and 4.2% of patients with contaminants, with no difference between groups (p = 0.67). The regression model determined that the presence of contaminants in preop-UC failed to predict postop-UTI (OR 0.69, p = 0.64). CONCLUSION: The presence of contaminants in preop-UCs is not associated with an increased risk of postop-UTIs after ureteroscopy. Our study supports that contaminants in the preop-UC can be interpreted as a negative UC in terms of postop-UTI risk stratification. Preoperative antibiotics should not be prescribed for patients undergoing uncomplicated ureteroscopy for stone surgery in the setting of a contaminated preop-UC.

Effects of arts and medicine salon events on wellness of participants.

Context: In the early 20th century artists and scientists would gather together for mutual fellowship in salons. These events would allow sharing of ideas and experiences and led to new creative endeavors. This type of interaction may lead to increased wellness. Primary care specialties see large volumes of patients which would benefit from physicians who are well versed in the humanities. These salon events may lead to increased humanities understanding as well as increased wellness. Objective: We sought to recreate these events in a 21st century environment. With the onset of the COVID-19 Pandemic, we switched events to a virtual format and chose to evaluate the impact of the events on the wellness of the participants. Study Design: We used a mixed methods survey to identify the impact and effectiveness of the virtual events. The survey used a combination of scaled and open-ended questions to evaluate the impact of the events and the pandemic on participants. Setting: 7 Arts & Medicine Salon events were held, 3 in person and 4 virtually. We analyzed the data from the virtual events. Population: Academic & Community Physicians, Scientists, Artists and learners training in those professions. Outcome Measures: We asked participants to rate and describe the impact of the Covid-19 pandemic on their wellbeing as well as the impact and effectiveness of the events both before and after the start of the global pandemic. Results: Both qualitative and quantitative data demonstrated a positive effect from the events on participants. The qualitative data was very strongly in favor of the events being helpful. The quantitative data was less exuberant. For some participants the events were felt to be integral to their ability to connect to the arts and other like-minded participants and were successful in mitigating the negative wellness effects of Covd-19. Conclusions: Learners and Professionals reported positive outcomes in both health and wellness from attending the virtual art and medicine salon events. There is a need for further research on the subject and experimentation with the events. This study was supported by a NIH Clinical and Translational Science Award Grant (UL1 TR002366) awarded to the University of Kansas Medical Center.