Skip to main content
SpringerLink
Log in

Urinary tract infection and antibiotic use around ureteral stent insertion for urolithiasis

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Urolithiasis is the main indication for a ureteral JJ stent. Our aim was to determine the incidence of urinary tract infections (UTIs) after a JJ stent for urolithiasis, with an emphasis on antibiotic use. Prospective, multicenter, cohort study over a 4-month period including all of the patients with urolithiasis requiring JJ stent insertion. The clinical and microbiological data and therapeutic information were recorded until removal of the JJ stent. Two hundred twenty-three patients at five French private hospitals were included. A urine culture was performed for 187 patients (84%) prior to insertion of a JJ stent, 36 (19%) of which were positive. One hundred thirty patients (58%) received an antibiotic therapy during surgery: 74 (33%) prophylaxis and 56 (25%) empirical antibiotic therapy, comprising 17 different regimens. The rate of prophylaxis varied according to the center, from 0 to 70%. A total of 208 patients were followed-up until removal of the first stent. The rate of UTIs was 6.3% (13/208); 8.1% of the patients who did not receive a prophylaxis had a UTI versus 1.4% of those who did receive a prophylaxis (p = 0.057). Seven empirical antibiotic regimens were used to treat these 13 patients. Another large panel of antibiotic prescriptions was observed at the time of JJ stent removal. The incidence of a UTI after JJ stent insertion for urolithiasis was 6.3%, in part due to a lack of prophylaxis. An unwarranted diversity of antibiotic use was observed at each step of care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69:475–482. https://doi.org/10.1016/j.eururo.2015.07.041

    Article  PubMed  Google Scholar 

  2. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M et al (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69:468–474. https://doi.org/10.1016/j.eururo.2015.07.040

    Article  PubMed  Google Scholar 

  3. Antibioprophylaxie en chirurgie et médecine interventionnelle (patients adultes) - La SFAR. Société Fr D’Anesthésie Réanimation 2018. https://sfar.org/antibioprophylaxie-en-chirurgie-et-medecine-interventionnelle-patients-adultes-maj2018/ (accessed April 1, 2019)

  4. Société de Pathologie Infectieuse de Langue Française (SPILF), Association Française d’Urologie (AFU), Société Française d’Hygiène Hospitalière (SF2H). Révision des recommandations de bonne pratique pour la prise en charge et la prévention des Infections Urinaires Associées aux Soins (IUAS) de l’adulte 2015

  5. Paick SH, Park HK, Oh S-J, Kim HH (2003) Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 62:214–217. https://doi.org/10.1016/S0090-4295(03)00325-X

    Article  PubMed  Google Scholar 

  6. Farsi HMA, Mosli HA, Al-Zemaity MF, Bahnassy AA, Alvarez M (1995) Bacteriuria and colonization of double-pigtail ureteral stents: long-term experience with 237 patients. J Endourol 9:469–472. https://doi.org/10.1089/end.1995.9.469

    Article  CAS  PubMed  Google Scholar 

  7. Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA et al (1998) Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 160:1260–1264

    Article  CAS  PubMed  Google Scholar 

  8. Damiano R, Oliva A, Esposito C, De Sio M, Autorino R, D’Armiento M (2002) Early and late complications of double pigtail ureteral stent. Urol Int 69:136–140. https://doi.org/10.1159/000065563

    Article  PubMed  Google Scholar 

  9. Pollard SG, Macfarlane R (1988) Symptoms arising from double-J ureteral stents. J Urol 139:37–38

    Article  CAS  PubMed  Google Scholar 

  10. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M et al (2007) 2007 guideline for the management of ureteral calculi. Eur Urol 52:1610–1631. https://doi.org/10.1016/j.eururo.2007.09.039

    Article  PubMed  Google Scholar 

  11. Chen Y-T, Chen J, Wong W-Y, Yang SS-D, Hsieh C-H, Wang C-C (2002) Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial. J Urol 167:1977–1980

    Article  PubMed  Google Scholar 

  12. Nabi G, Cook J, N’Dow J, McClinton S (2007) Outcomes of stenting after uncomplicated ureteroscopy: systematic review and meta-analysis. BMJ 334:572. https://doi.org/10.1136/bmj.39119.595081.55

    Article  PubMed  PubMed Central  Google Scholar 

  13. Borboroglu PG, Amling CL, Schenkman NS, Monga M, Ward JF, Piper NY et al (2001) Ureteral stenting after ureteroscopy for distal ureteral calculi: a multi-institutional prospective randomized controlled study assessing pain, outcomes and complications. J Urol 166:1651–1657

    Article  CAS  PubMed  Google Scholar 

  14. Haleblian G, Kijvikai K, de la Rosette J, Preminger G (2008) Ureteral stenting and urinary stone management: a systematic review. J Urol 179:424–430. https://doi.org/10.1016/j.juro.2007.09.026

    Article  PubMed  Google Scholar 

  15. Song T, Liao B, Zheng S, Wei Q (2012) Meta-analysis of postoperatively stenting or not in patients underwent ureteroscopic lithotripsy. Urol Res 40:67–77. https://doi.org/10.1007/s00240-011-0385-7

    Article  PubMed  Google Scholar 

  16. Smedley FH, Rimmer J, Taube M, Edwards L (1988) 168 double J (pigtail) ureteric catheter insertions: a retrospective review. Ann R Coll Surg Engl 70:377–379

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Jonas M, Jóźwik A, Kawecki D, Durlik M, Pączek L, Młynarczyk G et al (2016) Influence of double-J catheters on urinary infections after kidney transplantation. Transplant Proc 48:1630–1632. https://doi.org/10.1016/j.transproceed.2016.03.003

    Article  CAS  PubMed  Google Scholar 

  18. Osman Y, Ali-El-Dein B, Shokeir AA, Kamal M, Shehab El-Din AB (2005) Routine insertion of ureteral stent in live-donor renal transplantation: is it worthwhile? Urology 65:867–871. https://doi.org/10.1016/j.urology.2004.11.050

    Article  PubMed  Google Scholar 

  19. Wilson CH, Bhatti AA, Rix DA, Manas DM (2005) Routine intraoperative ureteric stenting for kidney transplant recipients. Cochrane Database Syst Rev:CD004925. https://doi.org/10.1002/14651858.CD004925.pub2

  20. Bruyère F, Sotto A, Escaravage L, Cariou G, Mignard J-P, Coloby P et al (2010) Recommandations de bonnes pratiques cliniques : l’antibioprophylaxie en chirurgie urologique, par le Comité d’infectiologie de l’association française d’urologie (CIAFU). Prog En Urol 20:101–108. https://doi.org/10.1016/j.purol.2009.11.003

    Article  Google Scholar 

  21. Mossanen M, Calvert JK, Holt SK, James AC, Wright JL, Harper JD et al (2015) Overuse of antimicrobial prophylaxis in community practice urology. J Urol 193:543–547. https://doi.org/10.1016/j.juro.2014.08.107

    Article  PubMed  Google Scholar 

  22. Roger P-M, Tabutin J, Blanc V, Léotard S, Brofferio P, Léculé F et al (2015) Prosthetic joint infection: a pluridisciplinary multi-center audit bridging quality of care and outcome. Med Mal Infect 45:229–236. https://doi.org/10.1016/j.medmal.2015.04.003

    Article  PubMed  Google Scholar 

  23. Mothes A, Léotard S, Nicolle I, Smets A, Chirio D, Rotomondo C et al (2016) Community-acquired pneumonia and positive urinary antigen tests: factors associated with targeted antibiotic therapy. Med Mal Infect 46:365–371. https://doi.org/10.1016/j.medmal.2016.05.009

    Article  CAS  PubMed  Google Scholar 

  24. Aillet C, Jammes D, Fribourg A, Léotard S, Pellat O, Etienne P et al (2018) Bacteraemia in emergency departments: effective antibiotic reassessment is associated with a better outcome. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 37:325–331. https://doi.org/10.1007/s10096-017-3136-z

    Article  CAS  Google Scholar 

  25. Roger PM, Michélangeli C, Girard D, Etienne P, Borredon G, Dautezac V et al (2019) Streamlined guidelines for antibiotic therapies are required for greater efficacy. Med Mal Infect 49:363–366. https://doi.org/10.1016/j.medmal.2019.02.001

    Article  CAS  PubMed  Google Scholar 

  26. Paterson DL (2004) “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis Off Publ Infect Dis Soc Am 38(Suppl 4):S341–S345. https://doi.org/10.1086/382690

    Article  CAS  Google Scholar 

  27. Souhail B, Le Maréchal M, Manuello R, Chrétien R, Charlot P, Déroudilhes G et al (2019) Antibiotic therapy for Enterococcus bacteraemia: warning for the antimicrobial stewardship team. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. https://doi.org/10.1007/s10096-019-03645-5

  28. Courjon J, Chirio D, Demonchy E, Michelangeli C, Degand N, Roger P-M (2019) Amoxicillin/clavulanic acid+aminoglycoside as empirical antibiotic treatment in severe community-acquired infections with diagnostic uncertainty. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 38:895–901. https://doi.org/10.1007/s10096-019-03496-0

    Article  CAS  Google Scholar 

  29. Curhan GC (2007) Epidemiology of stone disease. Urol Clin North Am 34:287–293. https://doi.org/10.1016/j.ucl.2007.04.003

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Réso-Infectio-PACA-Est, Nice, France

    Bérénice Souhail & Pierre-Marie Roger

  2. Elsan, Clinique Inkermann, 84 Rte d’Aiffres, 79000, Niort, France

    Patrick Charlot & Yves Coblentz

  3. Elsan, Clinique Saint Augustin, 114 Ave d’Arès, 33000, Bordeaux, France

    Gilles Deroudilhe & Gregory Pierquet

  4. Elsan, Clinique Saint-Roch 5 Rue Ambroise Croizat, 66330, Cabestany, France

    Pierre Gimel & Nathalie Challut

  5. Elsan, Clinique Vauban, 10 Avenue Vauban, 59300, Valenciennes, France

    Thierry Levent

  6. Elsan, Clinique du Sidobre, Chemin de St Hyppolyte, 81100, Castres, France

    Stéphane Cusumano & Véronique Dautezac

  7. Elsan, Clinique Les Fleurs,, Avenue Frédéric Mistral, 83190, Ollioules, France

    Pierre-Marie Roger

  8. Faculté de Médecine, Université Côte d’Azur, 28 Avenue de Valombrose, 06107, Nice, France

    Pierre-Marie Roger

Authors
  1. Bérénice Souhail
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patrick Charlot
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gilles Deroudilhe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yves Coblentz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gregory Pierquet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pierre Gimel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nathalie Challut
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Thierry Levent
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Stéphane Cusumano
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Véronique Dautezac
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Pierre-Marie Roger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bérénice Souhail.

Ethics declarations

Conflict of interest

all of the authors declare that they have no conflicts of interest.

Ethics approval

Antibiotic audit are sponsored by the French National Health Agency.

Informed consent

the patients or their relatives provided written consent for computerization of their personal data for hospitalization purposes and clinical research.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Souhail, B., Charlot, P., Deroudilhe, G. et al. Urinary tract infection and antibiotic use around ureteral stent insertion for urolithiasis. Eur J Clin Microbiol Infect Dis 39, 2077–2083 (2020). https://doi.org/10.1007/s10096-020-03953-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-020-03953-1

Keywords

Search

Navigation