Predictive Value of Urinary Cultures in Assessment of Microbial Colonization of Ureteral Stents

Lifshitz, David A.; Winkler, Harry; Groß, Michael; Sulkes, Jacqueline; Baniel, Jack; Livne, Pinhas M.

doi:10.1089/end.1999.13.735

Cited by 64 publications

(62 citation statements)

References 9 publications

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“…The role of CUC in predicting MUSC was discussed previously [2][3][4][5][6][7][8]. However, an exact differentiation between pathogens and contaminating organisms is missing in all studies, resulting in a higher rate of positive CUC when compared to our results.…”

Section: Discussioncontrasting

confidence: 51%

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Improved detection of microbial ureteral stent colonisation by sonication

et al. 2010

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Purpose The diagnosis of microbial ureteral stent colonisation (MUSC) is difficult, since routine diagnostic techniques do not accurately detect microorganisms embedded in biofilms. New methods may improve diagnostic yield and understanding the pathophysiology of MUSC. The aim of the present study was to evaluate the potential of sonication in the detection of MUSC and to identify risk factors for device colonisation. Methods Four hundred and eight polyurethane ureteral stents of 300 consecutive patients were prospectively evaluated. Conventional urine culture (CUC) was obtained prior to stent placement and device removal. Sonication was performed to dislodge adherent microorganisms. Data of patient sex and age, indwelling time and indication for stent placement were recorded. Results Sonicate-fluid culture detected MUSC in 36%. Ureteral stents inserted during urinary tract infection (UTI) were more frequently colonised (59%) compared to those placed in sterile urine (26%; P \ 0.001). Female sex (P \ 0.001) and continuous stenting (P \ 0.005) were significant risk factors for MUSC; a similar trend was observed in patients older than 50 years (P = 0.16). MUSC and indwelling time were positively correlated (P \ 0.005). MUSC was accompanied by positive CUC in 36%. Most commonly isolated microorganisms were Coagulase-negative staphylococci (18.3%), Enterococci (17.9%) and Enterobacteriaceae (16.9%). Conclusions Sonication is a promising approach in the diagnosis of MUSC. Significant risk factors for MUSC are UTI at the time of stent insertion, female sex, continuous stenting and indwelling time. CUC is a poor predictor of MUSC. The clinical relevance of MUSC needs further evaluation to classify isolated microorganism properly as contaminants or pathogens.

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Section: Discussioncontrasting

confidence: 51%

“…The issue of MUSC has not been well studied previously. Available data are inconsistent and controversial [2][3][4][5][6][7][8][9][10]. Microbiologic diagnosis of MUSC is difficult, since routine culture techniques do not accurately detect microorganisms embedded in biofilms.…”

Section: Introductionmentioning

confidence: 99%

Improved detection of microbial ureteral stent colonisation by sonication

et al. 2010

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“…and Staphylococcus epidermidis have been shown to be the most frequent colonising bacteria in such patients and may be found in up to a third of patients with pre-operative sterile urine. 9,10 Gentamicin in isolation can be ineffective against these pathogens in 25-50% of cases. Due to the wide variation in the choice of antibiotics, dosage and time of administration in our study, it is difficult to draw statistically valid conclusions, and a comprehensive discussion of antibiotic prophylaxis in PCNL is beyond the scope of this paper.…”

Section: Complicationsmentioning

confidence: 99%

Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK

Srirangam

Darling

Stopford

et al. 2008

annals

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Ann R Coll Surg Engl 2008; 90: 40-44 40Percutaneous nephrolithotomy (PCNL) has become the mainstay of treatment for large renal calculi over the past 30 years since Fernstrom and Johansson first removed a renal calculus through a nephrostomy tract in 1976. 1 The practice of PCNL, having been refined over time, continues to evolve and has largely replaced open stone surgery for the treatment of complex upper tract stones unsuitable for extracorporeal shockwave lithotripsy (ESWL) or ureteroscopy. This has been aided by advances in technology and equipment resulting in stone removal with less morbidity, shorter convalescence, and reduced cost compared with open surgery. 2,3 Excellent outcomes have been reported following PCNL with stone-free rates approaching 95%. Nevertheless, most published series of PCNL are from single centres with a dedicated sub-specialist interest in stone management.These represent optimum results achievable and may not reflect outcomes of everyday practice in non-specialised units. The aim of the study was to analyse the current practice of PCNL in our region. Patients and MethodsThe region comprises 12 participating hospital trusts. Of these, two were tertiary referral centres with a recognised expertise in stone management, while the rest (10) comprised district general hospitals (secondary centres) providing a range of urological interventions. All patients undergoing a PCNL procedure in 2002 were identified using theatre records and medical records scrutinised retrospectively. In trusts performing more than 20 procedures

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“…The ileal orthotopic bladder replacement is the most efficient way to reconstruct the urinary tract, both in women and in men [1][2][3][4]. Methods for orthotopic bladder construction described in literature recommend stenting of the ureterointestinal anastomosis as a standard precautionary procedure, irrespective of the method of constructing the anastomosis [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The rationale for stenting of the anastomosis includes protecting from the consequences of urine extravasation, and facilitating the fusion of intestinal and ureteral mucosa.…”

Section: Introductionmentioning

confidence: 99%

“…Optimal duration of stenting remains a topic of much debate and suggestions from several author ranges from 7 to 14 postoperative days [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The procedure of radical cystectomy with orthotopic bladder replacement carries a high risk of complications, mostly in the early postoperative period.…”

Section: Introductionmentioning

confidence: 99%

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2015

UNOAJ

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Predictive Value of Urinary Cultures in Assessment of Microbial Colonization of Ureteral Stents

Cited by 64 publications

References 9 publications

Improved detection of microbial ureteral stent colonisation by sonication

Improved detection of microbial ureteral stent colonisation by sonication

Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK

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