Abstract
Objective: We aimed to demonstrate the relationship between
urine analysis and culture of patients with DJ stents with significant urinary
infection and thus prevent unnecessary antibiotic use and over-treatment.
Material and Methods: The data of patients who had DJS insertion
between 2016 and 2019 were investigated retrospectively.
Results: A total of 152 patients were included in the
study. The mean age of the patients was 48.9±14.9 years. Indications for DJS
insertion were as follow: endoscopic ureter and kidney stone treatment was
percutaneous nephrolithotomy in 108 (71.2%) patients, percutaneous
nephrolithotomy in 20 (13.2%) patients and renal transplantation in 6 patients.
The urine analysis of the patients revealed nitrite (+) in 8 patients and
leukocyte esterase (+) in 117 patients (77%). In 20 patients (13.2%), various
microorganism growths were observed in urine culture. 75% of patients with
nitrite were positive in urine culture. No significant difference was found
between urine cultures of patients with and without comorbidity (p = 0.132). In
multivariate regression analysis, age, gender, catheter stay duration, and
indications for DJS were not found top predict urinary tract infection (p>
0.05 for all variables).
Conclusion: In patients with ureteral stent, nitrite
positivity predicts urinary tract infection at a high rate and necessitate
urine culture followed by appropriate antibiotic treatment.
References
- 1. Hao P, Li W, Song C, Yan J, Song B, Li L. Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases. J Endourol 2008;22:65-70.
- 2. Akay AF, Aflay U, Gedik A, Sahin H, Bircan MK. Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent. Int Urol Nephrol 2007;39:95-8.
- 3. Scotland KB, Lo J, Grgic T, Lange D. Ureteral stent-associated infection and sepsis: pathogenesis and prevention: a review. Biofouling 2019;35:117-27.
- 4. Kehinde EO, Rotimi VO, Al-Hunayan A, Abdul-Halim H, Boland F, Al-Awadi KA. Bacteriology of urinary tract infection associated with indwelling J ureteral stents. J Endourol 2004;18:891-6.
- 5. Kehinde EO, Rotimi VO, Al-Awadi KA, et al. Factors predisposing to urinary tract infection after J ureteral stent insertion. J Urol 2002;167:1334-7.
- 6. Paick SH, Park HK, Oh SJ, Kim HH. Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 2003;62:214-7.
- 7. Altunal N, Willke A, Hamzaoğlu O. Ureteral stent infections: a prospective study. Braz J Infect Dis 2017;21:361-4.
- 8. Elayarajah, Rajendran R, Venkatrajah, et al. Biodegradable tocopherol acetate as a drug carrier to prevent ureteral stent-associated infection. Pak J Biol Sci 2011;14:336-43.
Abstract
Amaç: Double J stent (DJS) takılan hastaların idrar
tahlili ve kültürünün anlamlı üriner enfeksiyon ile ilişkisini ortaya koymayı
ve bu sayede gereksiz antibiyotik kullanımı ve fazladan tedavinin önüne geçmeyi
planladık.
Gereç ve Yöntemler: 2016 ile 2019 yılları arasında çeşitli
sebeplerle DJS takılmış olan hastaların verileri retrospektif olarak incelendi.
Bulgular: Çalışmaya toplam 152 hasta dahil edildi.
Hastaların ortalama yaşı 48.9±14.9 yıl idi. DJS takılma endikasyonları: 108
(%71.2) hastada endoskopik üreter ve böbrek taşı tedavisi, 20 (%13.2) hastada
perkütan nefrolitotomi ve 6 hastada renal transplantasyon idi. Hastaların
yapılan idrar analizlerinde 8 hastada nitrit (+) bulunurken 117 hastada (%77)
ise lökosit esteraz (+) idi. 20 hastanın (%13.2) idrar kültüründe çeşitli
mikroorganizma üremeleri izlendi. Nitriti pozitif olan hastaların %75’inin
idrar kültüründe üreme oldu. Ek hastalığı olanlar ile olmayanların idrar
kültürlerinde mikroorganizma üreme açısından anlamlı farklılık saptanmadı (p=
0.132). Çok değişkenli regresyon analizinde yaş, cinsiyet, kateter kalış
süresi, DJS konulma endikasyonundan hiçbirinin idrar yolu enfeksiyonu
geliştirmeyi predikte etmediği görüldü (tüm değişkenler için p>0.05).
Sonuç: Üreteral stenti olan hastalarda idrar tetkikinde
nitrit pozitifliği üriner sistem enfeksiyonunu yüksek oranda predikte eder ve
idrar kültürünü takiben uygun antibiyotik ile tedaviyi gerektirir.
References
- 1. Hao P, Li W, Song C, Yan J, Song B, Li L. Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases. J Endourol 2008;22:65-70.
- 2. Akay AF, Aflay U, Gedik A, Sahin H, Bircan MK. Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent. Int Urol Nephrol 2007;39:95-8.
- 3. Scotland KB, Lo J, Grgic T, Lange D. Ureteral stent-associated infection and sepsis: pathogenesis and prevention: a review. Biofouling 2019;35:117-27.
- 4. Kehinde EO, Rotimi VO, Al-Hunayan A, Abdul-Halim H, Boland F, Al-Awadi KA. Bacteriology of urinary tract infection associated with indwelling J ureteral stents. J Endourol 2004;18:891-6.
- 5. Kehinde EO, Rotimi VO, Al-Awadi KA, et al. Factors predisposing to urinary tract infection after J ureteral stent insertion. J Urol 2002;167:1334-7.
- 6. Paick SH, Park HK, Oh SJ, Kim HH. Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 2003;62:214-7.
- 7. Altunal N, Willke A, Hamzaoğlu O. Ureteral stent infections: a prospective study. Braz J Infect Dis 2017;21:361-4.
- 8. Elayarajah, Rajendran R, Venkatrajah, et al. Biodegradable tocopherol acetate as a drug carrier to prevent ureteral stent-associated infection. Pak J Biol Sci 2011;14:336-43.
Details
| Primary Language | English |
|---|---|
| Subjects | Urology |
| Journal Section | Research Article |
| Authors | |
| Publication Date | February 26, 2020 |
| Published in Issue | Year 2020 Volume: 15 Issue: 1 |