Is Bacterial Colonization in Ureteral Double-J Stents Significant and Is It Predictable?/Ureteral Double J Stentlerde Bakteri Kolonizasyonu Anlamli midir ve Idrar Testleri ile Tahmin Edilebilir mi?

• Published in: Journal of urological surgery 2020-06, Vol.7 (2), p.120
• Main Authors: Sahan, Ahmet, Cubuk, Alkan, Ertas, Kasim, Garayev, Asgar, Talibzade, Ferhat, Sekerci, Cagri Akin, Toprak, Tuncay, Tanidir, Yiloren
• Format: Article
• Language: English
• Subjects: Analysis; Beta lactamases; Care and treatment; Health aspects; Imipenem; Infection; Medical research; Methicillin; Stents; Tetracyclines; Urinalysis
• ISSN: 2148-9580; 2148-9580
• DOI: 10.4274/jus.galenos.2019.3007

Objective: Since microscopic hematuria and pyuria can be observed in patients with a ureteral double-J (DJ) stent in place, urinalysis findings are not considered significant in terms of predicting stent-related infections. This study evaluates the presence of bacterial colonization and the value/effectiveness of urine tests in predicting the results of DJ stent cultures. Materials and Methods: In the present prospective study, we analyzed data from patients who were treated with a DJ stent placement following endourological surgery due to ureteral stones. DJ stents were removed only after the urine cultures appeared sterile or after a period of empiric antibiotic use. The relationship between urinalysis results and stent cultures was assessed. Results: A total of 65 patients (mean age, 42.6[+ or -]13.5 years; 16 females and 43 males) were evaluated. Bacterial colonization was detected in 12 (18%) DJ stent cultures with Enterococcus faecalis (n=4), extended-spectrum beta-lactamase producer (ESBL (+) Escherichia coli (n=4), Corynebacterium urealyticum (n=2), candida (n=1) and methicillin-resistant Staphylococcus aureus (n=1) growth being reported. The antibiogram results of the patients that showed colonization in their cultures demonstrated penicillin (n=4), ampicillin (n=4), tetracycline (n=3), imipenem (n=2), and linezolid (n=1) sensitivity. The rate of leukocyte esterase- and nitrite-positive patients, of those having significant number of leukocytes, and urine culture-positive patients in the groups with and without positive urine culture was 58.5%, 32%, 49%, and 7.5% vs 50%, 16.6%, 50%, and 8.5%, respectively. There were no statistically significant differences between the groups (p=>0.05). None of the study patients applied to our hospital with active infection following DJ stent removal. Conclusion: Urinalysis is insufficient in predicting catheter culture results. Based on the results of this study, we assume that stent culture for removed DJ stents is not a necessity; empirical antibiotic therapy with ampicillin-tetracycline should be started in patients with postoperative infection. Keywords: Double J stent, Colonization, Urinalysis, Stent culture Amac: Ureteral Double-J (DJ) stent takilan hastalarda mikroskobik hematuri ve piyuri siklikla eslik ettiginden, idrar analizleri enfeksiyonlari ongorme acisindan anlamli sayilmazlar. Bu calisma, ureteral DJ stent kultur sonuclarini ongormede idrar testlerinin degeri/ etkinligi degerlendirmektedir. Gerec