Ureteral Stent Induced Urinary Tract Infection and Microbial Inconsistency Between Bladder and Renal Pelvis
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Purpose: This study examined the effects of long-term ureteral stent (US) on urinary tract infection (UTI) by bacterial migration and bacterial colonization. Materials and Methods: From March 2014 to August 2021, 64 patients who underwent US for more than six months were enrolled in this study. When the US was inserted for the first time and replaced regularly, urine was collected from the bladder and renal pelvis and cultured. Patients’ the characteristics, and differences in pathogens related to US infection were analyzed. Results: The mean age was 66.4 years, and the mean duration of indwelling was 37.5 months. There were 38 cases (59.3%) by malignant and 26 cases (40.6%) by benign causes. UTI occurred in 33 cases (53%); 16 cases (25%) were hospitalized for febrile UTI. After the initial US insertion, bacteria were identified in the bladder 285 days later and in the renal pelvis after 619 days. The bladder culture was positive in 10 of the 33 patients, and renal pelvis alone was positive in nine of the 33 patients. The same strain was confirmed in the bladder and renal pelvis in 12 cases (18.8%), and it took a mean of 5.8 months ± 6.32 (standard deviation) for the upward migration of bacteria. Conclusions: UTIs occur in approximately 50% of patients with long-term US indwelling. The probability of culturing the same strain by a US was approximately 18.8%, and the role of pathogen transmission of a US does not appear to be significant. In addition, renal pelvis culture would be helpful in cases of failed bladder antibiotics susceptibility.
Abstract
Purpose: This study examined the effects of long-term ureteral stent (US) on urinary tract infection (UTI) by bacterial migration and bacterial colonization. Materials and Methods: From March 2014 to August 2021, 64 patients who underwent US for more than six months were enrolled in this study. When the US was inserted for the first time and replaced regularly, urine was collected from the bladder and renal pelvis and cultured. Patients’ the characteristics, and differences in pathogens related to US infection were analyzed. Results: The mean age was 66.4 years, and the mean duration of indwelling was 37.5 months. There were 38 cases (59.3%) by malignant and 26 cases (40.6%) by benign causes. UTI occurred in 33 cases (53%); 16 cases (25%) were hospitalized for febrile UTI. After the initial US insertion, bacteria were identified in the bladder 285 days later and in the renal pelvis after 619 days. The bladder culture was positive in 10 of the 33 patients, and renal pelvis alone was positive in nine of the 33 patients. The same strain was confirmed in the bladder and renal pelvis in 12 cases (18.8%), and it took a mean of 5.8 months ± 6.32 (standard deviation) for the upward migration of bacteria. Conclusions: UTIs occur in approximately 50% of patients with long-term US indwelling. The probability of culturing the same strain by a US was approximately 18.8%, and the role of pathogen transmission of a US does not appear to be significant. In addition, renal pelvis culture would be helpful in cases of failed bladder antibiotics susceptibility.
참고문헌 (29)
- Sali GM, "Ureteric stents : overview of current clinical applications and economic implications", Int J Urol, 27, pp.7~15 (2020)
- de la Rosette J, "The clinical research office of the Endourological Society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients", J Endourol, 28, pp.131~139 (2014)
- Tabib C, "Management and treatment options when facing malignant ureteral obstruction", Int J Urol, 27, pp.591~598 (2020)
- Koprowski C, "Ureteral stent-associated pain : a review", J Endourol, 30, pp.744~753 (2016)
- Fischer KM, "Ureteral stent discomfort and its management", Curr Urol Rep, 19, pp.64~ (2018)
- Akay AF, "Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent", Int Urol Nephrol, 39, pp.95~98 (2007)
- Al-Ghazo MA, "The risk of bacteriuria and ureteric stent colonization in immune-compromised patients with double J stent insertion", Int Urol Nephrol, 42, pp.343~347 (2010)
- Joshi R, "Lower urinary tract infection and bacterial colonization in patient with double J ureteral stent", J Nepal Health Res Counc, 9, pp.165~168 (2011)
- Liaw A, "Urinary tract infections associated with ureteral stents : a review", Arch Esp Urol, 69, pp.479~484 (2016)
- Kram W, "Ureteral stent encrustation. Pathophysiology", Arch Esp Urol, 69, pp.485~493 (2016)
- Scotland KB, "Ureteral stent-associated infection and sepsis : pathogenesis and prevention : a review", Biofouling, 35, pp.117~127 (2019)
- Gupta K, "Urinary tract infection", Ann Intern Med, 167, pp.ITC49~ITC64 (2017)
- Johnson JR, "Acute pyelonephritis in adults", N Engl J Med, 378, pp.48~59 (2018)
- Tsukanov AY, "The impact of ureteral stent surface on encrustation and biofilm formation", Urologiia, 2, pp.40~45 (2018)
- Zhang JM, "Observations of bacterial biofilm on ureteral stent and studies on the distribution of pathogenic bacteria and drug resistance", Urol Int, 101, pp.320~326 (2018)
- Sountoulides P, "Does ureteral stenting increase the risk of metachronous upper tract urothelial carcinoma in patients with bladder tumors? A systematic review and meta-analysis", J Urol, 205, pp.956~966 (2021)
- Chew BH, "Advances in ureteral stent development", Curr Opin Urol, 26, pp.277~282 (2016)
- Chew BH, "Impact of ureteral stenting in ureteroscopy", Curr Opin Urol, 26, pp.76~80 (2016)
- Chugh S, "Predictors of urinary infections and urosepsis after ureteroscopy for stone disease : a systematic review from EAU section of urolithiasis(EULIS)", Curr Urol Rep, 21, pp.16~ (2020)
- Lange D, "Ureteral stent-associated complications--where we are and where we are going", Nat Rev Urol, 12, pp.17~25 (2015)
- Lundeen CJ, "Ureteral stents : the good the bad and the ugly", Curr Opin Urol, 30, pp.166~170 (2020)
- 김봉영, "Descriptive Epidemiology of Acute Pyelonephritis in Korea, 2010–2014: Population-based Study", Journal of Korean Medical Science, 33(49), pp.1~11 (2018), 대한의학회
- Karsiyakali N, "Renal pelvis urine Gram stain as a traditional, but new marker in predicting postoperative fever and stone culture positivity in percutaneous nephrolithotomy : an observational, prospective, non-randomized cohort study", World J Urol, 39, pp.2135~2146 (2021)
- Yoshida S, "The significance of intraoperative renal pelvic urine and stone cultures for patients at a high risk of post-ureteroscopy systemic inflammatory response syndrome", Urolithiasis, 47, pp.533~540 (2019)
- Soria F, "Antireflux ureteral stent proof of concept assessment after minimally invasive treatment of obstructive uropathy in animal model", Arch Esp Urol, 71, pp.607~613 (2018)
- Forbes C, "Innovations in ureteral stent technology", Urol Clin North Am, 46, pp.245~255 (2019)
- Benson AD, "Metal ureteral stent for benign and malignant ureteral obstruction", J Urol, 185, pp.2217~2222 (2011)
- Sampogna G, "Expandable metallic ureteral stent : indications and results", Minerva Urol Nefrol, 70, pp.275~285 (2018)
- Kallidonis P, "The effectiveness of ureteric metal stents in malignant ureteric obstructions: a systematic review", Arab J Urol, 15, pp.280~288 (2017)