Urinary Tract Infection and Predisposing Factors in Patients with Ureteral Stents

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.

Keywords

• Ureteral stent,urinary tract infection,urinalysis,urine culture

Üreteral Stenti Olan Hastalarda Üriner Sistem Enfeksiyonu ve Predispozan Faktörler

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.

Keywords

• Üreteral stent,üriner sistem enfeksiyonu,idrar tahlili,idrar kültürü

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