Bacteriology of urinary tract infection associated with indwelling J ureteral stents

Elijah O. Kehinde, Vincent O. Rotimi, Adel Al-Hunayan, Hamdy Abdul-Halim, Fareeda Boland, Khaleel A. Al-Awadi

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Purpose: To investigate the microorganisms responsible for urinary tract infection (UTI) and stent colonization in patients with indwelling J ureteral stents and to compare the antimicrobial susceptibility pattern of the isolates from urine and J stents in order to establish the etiologic agents of bacteriuria and colonized stents in such patients and provide baseline data on an antibiotic policy for the urology unit. Patients and Methods: Midstream urine from 250 patients requiring J stent insertion was investigated microbiologically prior to stent insertion and on the day of stent removal. After stent removal, 3 to 5 cm of the tip located in the bladder was also sent for culture. Patients' bio-data and underlying diseases were documented. Those with no known systemic diseases ("normal patients") were also studied as controls. Of the 250 patients studied, 152 (61%) were normal, while 27 (11%), 53 (21%), and 18 (7%) had diabetes mellitus (DM), chronic renal failure (CRF), and diabetic nephropathy (DN), respectively. The mean duration of stent retention was 27 days. All microbial isolates were tested for their susceptibility to a panel of 10 antibiotics. Results: Twelve patients (5%) before stent insertion and 42 patients (17%; P < 0.001) on the day of stent removal had positive urine cultures. One hundred four stents (42%) were culture positive. Of the 104 patients with positive stent cultures, in 62 patients (60%), urine culture was sterile. The commonest isolates were Escherichia coli, Enterococcus spp., Staphylococcus spp., Pseudomonas, and Candida spp. On the day of stent removal, urine culture was positive in 28% of the normal patients compared with 57% (P = 0.11), 78% (P < 0.001), and 62% (P < 0.001) of patients with CRF, DM, and DN, respectively. Stent isolates were more resistant to antibiotics than the organism isolated before stent insertion. Conclusion: An indwelling J ureteral stent carries a significant risk of bacteriuria and stent colonization. The sensitivity of urine culture to stent colonization is low, and therefore, a negative culture does not rule out a colonized stent. Bacteria cultured from urine after stent insertion and from the stents are more resistant to antibiotics than are those cultured from urine before stent insertion. Norfloxacin or ciprofloxacin is recommended as prophylaxis prior to stent insertion, and an aminoglycoside can be added to treat symptomatic patients with severe infections.

Original languageEnglish
Pages (from-to)891-896
Number of pages6
JournalJournal of Endourology
Volume18
Issue number9
Publication statusPublished - Nov 2004
Externally publishedYes

Fingerprint

Bacteriology
Urinary Tract Infections
Stents
Urine
Anti-Bacterial Agents
Bacteriuria
Diabetic Nephropathies
Chronic Kidney Failure
Diabetes Mellitus

ASJC Scopus subject areas

  • Urology

Cite this

Kehinde, E. O., Rotimi, V. O., Al-Hunayan, A., Abdul-Halim, H., Boland, F., & Al-Awadi, K. A. (2004). Bacteriology of urinary tract infection associated with indwelling J ureteral stents. Journal of Endourology, 18(9), 891-896.

Bacteriology of urinary tract infection associated with indwelling J ureteral stents. / Kehinde, Elijah O.; Rotimi, Vincent O.; Al-Hunayan, Adel; Abdul-Halim, Hamdy; Boland, Fareeda; Al-Awadi, Khaleel A.

In: Journal of Endourology, Vol. 18, No. 9, 11.2004, p. 891-896.

Research output: Contribution to journalArticle

Kehinde, EO, Rotimi, VO, Al-Hunayan, A, Abdul-Halim, H, Boland, F & Al-Awadi, KA 2004, 'Bacteriology of urinary tract infection associated with indwelling J ureteral stents', Journal of Endourology, vol. 18, no. 9, pp. 891-896.
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. Journal of Endourology. 2004 Nov;18(9):891-896.
Kehinde, Elijah O. ; Rotimi, Vincent O. ; Al-Hunayan, Adel ; Abdul-Halim, Hamdy ; Boland, Fareeda ; Al-Awadi, Khaleel A. / Bacteriology of urinary tract infection associated with indwelling J ureteral stents. In: Journal of Endourology. 2004 ; Vol. 18, No. 9. pp. 891-896.
@article{644821ac6fc943169e5bd3ed9a1697bd,
title = "Bacteriology of urinary tract infection associated with indwelling J ureteral stents",
abstract = "Purpose: To investigate the microorganisms responsible for urinary tract infection (UTI) and stent colonization in patients with indwelling J ureteral stents and to compare the antimicrobial susceptibility pattern of the isolates from urine and J stents in order to establish the etiologic agents of bacteriuria and colonized stents in such patients and provide baseline data on an antibiotic policy for the urology unit. Patients and Methods: Midstream urine from 250 patients requiring J stent insertion was investigated microbiologically prior to stent insertion and on the day of stent removal. After stent removal, 3 to 5 cm of the tip located in the bladder was also sent for culture. Patients' bio-data and underlying diseases were documented. Those with no known systemic diseases ({"}normal patients{"}) were also studied as controls. Of the 250 patients studied, 152 (61{\%}) were normal, while 27 (11{\%}), 53 (21{\%}), and 18 (7{\%}) had diabetes mellitus (DM), chronic renal failure (CRF), and diabetic nephropathy (DN), respectively. The mean duration of stent retention was 27 days. All microbial isolates were tested for their susceptibility to a panel of 10 antibiotics. Results: Twelve patients (5{\%}) before stent insertion and 42 patients (17{\%}; P < 0.001) on the day of stent removal had positive urine cultures. One hundred four stents (42{\%}) were culture positive. Of the 104 patients with positive stent cultures, in 62 patients (60{\%}), urine culture was sterile. The commonest isolates were Escherichia coli, Enterococcus spp., Staphylococcus spp., Pseudomonas, and Candida spp. On the day of stent removal, urine culture was positive in 28{\%} of the normal patients compared with 57{\%} (P = 0.11), 78{\%} (P < 0.001), and 62{\%} (P < 0.001) of patients with CRF, DM, and DN, respectively. Stent isolates were more resistant to antibiotics than the organism isolated before stent insertion. Conclusion: An indwelling J ureteral stent carries a significant risk of bacteriuria and stent colonization. The sensitivity of urine culture to stent colonization is low, and therefore, a negative culture does not rule out a colonized stent. Bacteria cultured from urine after stent insertion and from the stents are more resistant to antibiotics than are those cultured from urine before stent insertion. Norfloxacin or ciprofloxacin is recommended as prophylaxis prior to stent insertion, and an aminoglycoside can be added to treat symptomatic patients with severe infections.",
author = "Kehinde, {Elijah O.} and Rotimi, {Vincent O.} and Adel Al-Hunayan and Hamdy Abdul-Halim and Fareeda Boland and Al-Awadi, {Khaleel A.}",
year = "2004",
month = "11",
language = "English",
volume = "18",
pages = "891--896",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "9",

}

TY - JOUR

T1 - Bacteriology of urinary tract infection associated with indwelling J ureteral stents

AU - Kehinde, Elijah O.

AU - Rotimi, Vincent O.

AU - Al-Hunayan, Adel

AU - Abdul-Halim, Hamdy

AU - Boland, Fareeda

AU - Al-Awadi, Khaleel A.

PY - 2004/11

Y1 - 2004/11

N2 - Purpose: To investigate the microorganisms responsible for urinary tract infection (UTI) and stent colonization in patients with indwelling J ureteral stents and to compare the antimicrobial susceptibility pattern of the isolates from urine and J stents in order to establish the etiologic agents of bacteriuria and colonized stents in such patients and provide baseline data on an antibiotic policy for the urology unit. Patients and Methods: Midstream urine from 250 patients requiring J stent insertion was investigated microbiologically prior to stent insertion and on the day of stent removal. After stent removal, 3 to 5 cm of the tip located in the bladder was also sent for culture. Patients' bio-data and underlying diseases were documented. Those with no known systemic diseases ("normal patients") were also studied as controls. Of the 250 patients studied, 152 (61%) were normal, while 27 (11%), 53 (21%), and 18 (7%) had diabetes mellitus (DM), chronic renal failure (CRF), and diabetic nephropathy (DN), respectively. The mean duration of stent retention was 27 days. All microbial isolates were tested for their susceptibility to a panel of 10 antibiotics. Results: Twelve patients (5%) before stent insertion and 42 patients (17%; P < 0.001) on the day of stent removal had positive urine cultures. One hundred four stents (42%) were culture positive. Of the 104 patients with positive stent cultures, in 62 patients (60%), urine culture was sterile. The commonest isolates were Escherichia coli, Enterococcus spp., Staphylococcus spp., Pseudomonas, and Candida spp. On the day of stent removal, urine culture was positive in 28% of the normal patients compared with 57% (P = 0.11), 78% (P < 0.001), and 62% (P < 0.001) of patients with CRF, DM, and DN, respectively. Stent isolates were more resistant to antibiotics than the organism isolated before stent insertion. Conclusion: An indwelling J ureteral stent carries a significant risk of bacteriuria and stent colonization. The sensitivity of urine culture to stent colonization is low, and therefore, a negative culture does not rule out a colonized stent. Bacteria cultured from urine after stent insertion and from the stents are more resistant to antibiotics than are those cultured from urine before stent insertion. Norfloxacin or ciprofloxacin is recommended as prophylaxis prior to stent insertion, and an aminoglycoside can be added to treat symptomatic patients with severe infections.

AB - Purpose: To investigate the microorganisms responsible for urinary tract infection (UTI) and stent colonization in patients with indwelling J ureteral stents and to compare the antimicrobial susceptibility pattern of the isolates from urine and J stents in order to establish the etiologic agents of bacteriuria and colonized stents in such patients and provide baseline data on an antibiotic policy for the urology unit. Patients and Methods: Midstream urine from 250 patients requiring J stent insertion was investigated microbiologically prior to stent insertion and on the day of stent removal. After stent removal, 3 to 5 cm of the tip located in the bladder was also sent for culture. Patients' bio-data and underlying diseases were documented. Those with no known systemic diseases ("normal patients") were also studied as controls. Of the 250 patients studied, 152 (61%) were normal, while 27 (11%), 53 (21%), and 18 (7%) had diabetes mellitus (DM), chronic renal failure (CRF), and diabetic nephropathy (DN), respectively. The mean duration of stent retention was 27 days. All microbial isolates were tested for their susceptibility to a panel of 10 antibiotics. Results: Twelve patients (5%) before stent insertion and 42 patients (17%; P < 0.001) on the day of stent removal had positive urine cultures. One hundred four stents (42%) were culture positive. Of the 104 patients with positive stent cultures, in 62 patients (60%), urine culture was sterile. The commonest isolates were Escherichia coli, Enterococcus spp., Staphylococcus spp., Pseudomonas, and Candida spp. On the day of stent removal, urine culture was positive in 28% of the normal patients compared with 57% (P = 0.11), 78% (P < 0.001), and 62% (P < 0.001) of patients with CRF, DM, and DN, respectively. Stent isolates were more resistant to antibiotics than the organism isolated before stent insertion. Conclusion: An indwelling J ureteral stent carries a significant risk of bacteriuria and stent colonization. The sensitivity of urine culture to stent colonization is low, and therefore, a negative culture does not rule out a colonized stent. Bacteria cultured from urine after stent insertion and from the stents are more resistant to antibiotics than are those cultured from urine before stent insertion. Norfloxacin or ciprofloxacin is recommended as prophylaxis prior to stent insertion, and an aminoglycoside can be added to treat symptomatic patients with severe infections.

UR - http://www.scopus.com/inward/record.url?scp=10344238973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10344238973&partnerID=8YFLogxK

M3 - Article

VL - 18

SP - 891

EP - 896

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 9

ER -