Ureteral stent infections: a prospective study

Altunal, Nilsun; Willke, Ayşe; Hamzaoğlu, Onur

doi:10.1016/j.bjid.2016.12.004

Cited by 19 publications

(14 citation statements)

References 5 publications

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“…4,27,38 It is unclear what effect the aging process does to alter the urinary microbiota; however, the observed decrease in protective urinary lactobacilli may account for common stent-associated UTI and encrustation in older populations. 39,40 Patients with IBS and IBD had increased stent and urinary presence of Prevotella and Veillonella species and decreased lactobacilli. These findings are consistent with previous literature on the gut microbiota in these conditions.…”

Section: Discussionmentioning

confidence: 99%

Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Denstedt

Daisley

et al. 2020

Cell Reports Medicine

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Summary Ureteral stents are commonly used to prevent urinary obstruction but can become colonized by bacteria and encrusted, leading to clinical complications. Despite recent discovery and characterization of the healthy urinary microbiota, stent-associated bacteria and their impact on encrustation are largely underexplored. We profile the microbiota of patients with typical short-term stents, as well as over 30 atypical cases (all with paired mid-stream urine) from 241 patients. Indwelling time, age, and various patient comorbidities correlate with alterations to the stent microbiota composition, whereas antibiotic exposure, urinary tract infection (UTI), and stent placement method do not. The stent microbiota most likely originates from adhesion of resident urinary microbes but subsequently diverges to a distinct, reproducible population, thereby negating the urine as a biomarker for stent encrustation or microbiota. Urological practice should reconsider standalone prophylactic antibiotics in favor of tailored therapies based on patient comorbidities in efforts to minimize bacterial burden, encrustation, and complications of ureteral stents.

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Section: Discussionmentioning

confidence: 99%

Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Denstedt

Daisley

et al. 2020

Cell Reports Medicine

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“…In addition to the aforementioned mechanical complications of ureteroscopy, lithotripsy, and stent placement, there are some additional infectious complications. The placement of ureteral stents has been associated with the formation of biofilms, resulting in complicated UTIs [ 11 ]. Biofilms are more commonly seen in patients with diabetes and chronic kidney disease [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Peri-Ureteral Abscess Formation Following Ureteroscopic Laser Lithotripsy: A Case Report

Hammond¹,

Grekoski²,

Boukai³

et al. 2022

Cureus

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We report the case of a patient with a previous history of obstructive renal calculus disease who initially presented with a symptomatic calculus in her right mid-ureter, requiring ureteroscopy with laser lithotripsy and ureteral stent placement. Shortly after the removal of the stent, the patient was found to have a periureteral abscess, necessitating percutaneous drainage by interventional radiology, and placement of an additional ureteral stent. Adverse reactions to these procedures are rare and, to our knowledge, this is the only documented case of peri-ureteral abscess as a complication of ureteroscopic laser lithotripsy or of ureteral stenting. In addition to developing a peri-ureteral abscess, this patient also experienced deep vein thrombosis (DVT) and subsegmental pulmonary embolism (PE), which also have not been found to be a common complication of laser lithotripsy or ureteral stent placement in any of the studies that we reviewed for this article. The complications that were previously rare are unfortunately on the rise, possibly in the setting of both increased access to invasive therapies as well as the increased rates of diabetes and obesity. Survivability hinges on prompt recognition and treatment of these complications. In the event that a peri-ureteral abscess is discovered, prompt treatment with broad-spectrum antibiotics is recommended in addition to interventional radiology and urology consultation. Antibiotics should cover conventional intraabdominal and urologic abscess regimens.

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“…The independent risk factors for the development of UTI were DM, chronic renal failure, and pregnancy. Altuna et al 18 demonstrated that UTI was more common in patients with ureteral stents with DM and chronic renal failure.…”

Section: Discussionmentioning

confidence: 99%

Risk factors in bacterial colonization of internal ureteral stent

Shaker

Chaloob

2021

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A ureteral stent is most broadly used to manage upper urinary tract disorders such as obstruction and prevent post-endoscopic complications. However, the stent may become a niche for bacterial colonization. This study aimed to determine the rate of bacterial colonization and type of bacteria in internal ureteral stents and the risk factors associated with bacterial colonization. This prospective cross-sectional study included 100 consecutive adult patients who had temporary ureteral stenting as preparation for a secondary ureterorenoscopy at Al-Yarmook Hospital/ Baghdad. All included patients were negative for bacterial culture before stenting. Stent and urine culture were performed at the time of stent removal. The colonization rate and bacteriuria in patients with internal ureteral stent were 19% and 9%, respectively. The most common bacteria in-stent and urine were E. coli accounting for 31.58% and 33.33%. Pseudomonas aeruginosa was common in stent culture, representing 21.05%. Positive bacterial culture was confirmed in 19 stents and 9 urine samples. All cases with positive urine samples were also positive for culture. Thus, the sensitivity and specificity of urine culture for detection of stent colonization were 47.37% and 100%, respectively. Diabetes mellitus, chronic renal failure, and prolonged stenting were significantly associated with increased stent colonization. The ureteral stent could be a source of urinary tract infection. The most pathogenic bacteria associated with the ureter stent are E. coli and Pseudomonas aeruginosa. Risk factors associated with stent colonization are diabetes mellitus, chronic renal failure, and prolonged indwelling time.

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Ureteral stent infections: a prospective study

Cited by 19 publications

References 5 publications

Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Peri-Ureteral Abscess Formation Following Ureteroscopic Laser Lithotripsy: A Case Report

Risk factors in bacterial colonization of internal ureteral stent

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