Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent

Akay, Ali; Aflay, Uğur; Gedik, Abdullah; Şahın, Hayrettin; Bircan, Mehmet Kamuran

doi:10.1007/s11255-006-9150-1

Cited by 71 publications

(79 citation statements)

References 15 publications

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“…Unlike other institutions in which the most frequently detected microorganism is E. Coli [14][15][16]21] and Enterococci spp [13,17,19,20], the bacterial flora in our clinic seems to be different. The gram positive uropathogens and particularly staphylococcus prevailed over the rest of the gram positives and negatives.…”

Section: Discussioncontrasting

confidence: 62%

“…Approximately 75% of our patients hosted at least one microorganism. This is a relatively high figure compared to other publications in which the correspond- ing rates were below 50% for a mean duration of catheterization between 2 and 9 weeks [13][14][15][16][17][18]. In only 1 paper, the adhesion rate ranged between 70 and 100% [19] and in another one, it was 90% [8].…”

Section: Discussionmentioning

confidence: 53%

“…It has been proposed that pregnancy and chronic diseases such as DM and CRF are correlated with the hosts' immunologic system impairment, which predisposes to UTI and stent colonization [1,14]. In one study, diabetic nephropathy and CRF (but not DM) were associated with the bacterial adhesion process [1].…”

Section: Discussionmentioning

confidence: 99%

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Is There a Role for Double J Stent Culture in Contemporary Urology?

et al. 2018

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Introduction: To present the incidence of bacterial colonization on ureteral double J stents (DJS); isolate the uropathogens; define the rate of multi-resistant bacteria strains (MRBS) and present their clinical importance. Materials and Methods: The whole body of 105 DJSs was examined for the presence of uropathogens. Results: The main etiology for stent placement was lithiasis (57.1%). The most frequently cultured microorganisms were staphylococcus (28.6%). Forty-four stents hosted MRBS. 25 (23.8%), 10 (9.5%) and 8 (7.6%) of the patients were affected by malignancy, diabetes mellitus and chronic renal failure respectively. Apart from the female gender, none of the examined factors (age, duration of stenting and chronic diseases) was correlated with the colonization or the presence of MRBS. Eleven of the 61 stented patients (18%) who were operated upon developed a febrile urinary tract infections (UTI). In 7 of them the stent hosted MRBS (63.6%). After taking into consideration the sensitivity report, we altered our initial empirical antibacterial prophylaxis to targeted antibacterial treatment in the patients with MRBS with rapid remission of their infection and no urosepsis event. Conclusion: The knowledge of bacteriologic flora of DJS can be very helpful in an evidence-based prophylactic and therapeutic practice. Stent examination could be recommended in high-risk cases of developing UTI and sepsis after a urologic operation.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 53%

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Is There a Role for Double J Stent Culture in Contemporary Urology?

et al. 2018

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“…Therefore, complications related to different types of CUUT are becoming increasingly important [18,19] . Infectious complications are the most frequent as CUUT may be associated with significant morbidity and even death [20] .…”

Section: Discussionmentioning

confidence: 99%

Urinary Infections in Patients with Catheters in the Upper Urinary Tract: Microbiological Study

et al. 2017

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Background: Infections related to catheters in the upper urinary tract (CUUT) are associated with specific characteristics. Methods: A prospective observational study was carried out from 2012 to 2015 to evaluate infections in patients with CUUT. Results: A total of 209 infections were included (99 with double-J, 81 with nephrostomy, and 29 with internal/external nephroureteral stents). Among nephrostomy tube carriers, the most frequently isolated microorganisms were Pseudomonas and Enterococcus. In those with an internal/external nephroureteral stent, Klebsiella was the most common, and 57.1% were extended-spectrum beta-lactamase-producing Klebsiella. In double-J carriers, Escherichia coli and Enterococcus were the most common microorganisms. Multiple-drug resistance (MDR) microorganisms were isolated in 28.6, 47.1, and 58.3% of patients with double-J, nephrostomy, and internal-external nephroureteral stents. A percutaneous CUUT (p = 0.005) and immunosuppression (p = 0.034) were risk factors for MDR microorganisms. Conclusions: Non-E. coli bacteria are commonly isolated in patients with CUUT. MDR microorganisms are frequent, mainly in percutaneous approach or immunosuppression.

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“…In addition, Akay et al [10] reported that DM, chronic renal failure and pregnancy were risk factors for lower tract UTI in patients with D-J stent insertion. Importantly, Paz et al [11] reported that in 100 cases with D-J insertion, elective cases (non-emergent cases) had a procedure-relating febrile infection rate of 6% at the time of exchange, though comparisons were complicated by differences in the patients' backgrounds.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Infectious Complication and Its Risk Factors after Urological Procedures of the Upper Urinary Tract

et al. 2011

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Background:Invasive upper urinary tract procedures such as retrograde pyelography (RP) or single (S-J) or double J (D-J) stenting are commonly performed to assess or treat ureteral strictures. Urinary tract infection (UTI) can result after such procedures, and prophylactic antimicrobial administration (PAA) may be necessary. This study investigated infectious complications and risk factors, focusing on PAA. Methods:We studied antimicrobial prevention in 353 upper urinary tract examinations or treatments. Procedures included S-J or D-J installation or exchange, RP and percutaneous nephrostomy. We investigated PAA and the occurrence of febrile infectious complications with respect to each procedure and attempted to find the risk factors. Results:Levofloxacin was used in 149 subjects (42.2%) and cefcapene pivoxil in 114 cases (32.3%). There were 16 febrile infectious complication cases (4.5%) after procedures, and pyuria or hydronephrosis prior to examination or treatment was an independent risk factor for infectious complication (p < 0.05) as well. Conclusions:These data showed that it is necessary to evaluate the risk factors before urological procedures of the upper urinary tract and to offer a definite preventive methodology according to these risk factors for the establishment and update of guidelines.

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Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent

Abstract: Diabetes mellitus, chronic renal failure, and pregnancy are associated with a higher risk of lower urinary tract infection. Therefore, patients in these categories should be monitored carefully for infectious complications.

Cited by 71 publications

References 15 publications

Is There a Role for Double J Stent Culture in Contemporary Urology?

Is There a Role for Double J Stent Culture in Contemporary Urology?

Urinary Infections in Patients with Catheters in the Upper Urinary Tract: Microbiological Study

Prevention of Infectious Complication and Its Risk Factors after Urological Procedures of the Upper Urinary Tract

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