Abstract
Purpose
Current American Urological Association guidelines recommend pre-operative antimicrobial therapy based on prior urine cultures (UC); however, the role of stent culture (SC) in urologic practice is unclear. We examined whether UC and SC differed at the time of stent removal, as well as the association, microbiology, and timing of subsequent UTIs as related to SC.
Methods
This was a retrospective review of 159 patients with ureteral stents for indications of urolithiasis, benign stricture, malignant obstruction, and kidney transplant. UC and SC were analyzed at the time of stent removal. Patients were followed for 12 months after stent removal for development, concordance, and timing of clinical UTIs.
Results
In 159 patients, 15% had positive UC and 45% had positive SC. Of patients who had positive SC, 66% had negative UC. All patients with positive UC had identical micro-organisms on SC; however, 33% of these had SC with additional micro-organisms. Relative to those with both negative UC and SC, patients with negative UC and positive SC had a 5.7 odds, and those with both positive UC and SC had a 13.6 odds of developing a clinical UTI within 12 months. Concordance of SC and future UTI was highest in those with post-operative sepsis, and those with Candida species on SC.
Conclusions
SC was a unique risk factor for development of UTI within 12 months of stent removal. Clinicians should consider SC results when empirically treating those with post-operative sepsis or those with UTI after Candida on SC.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of data and material
Available if needed.
Code availability
Not applicable.
References
Koo H, Allan RN, Howlin R et al (2017) Targeting microbial biofilms: current and prospective therapeutic strategies. Nat Rev Microbiol 15(12):740–755
Akay A, Aflay U, Gedik A et al (2007) Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent. Int Urol Nephrol 39(1):95–98. https://doi.org/10.1007/s11255-006-9150-1 (Epub 2006 Dec 14)
Aydin HR, Irkilata L, Aydin M et al (2016) Incidence of bacterial colonisation after indwelling of double-J ureteral stent. Arch Ital Urol Androl 87(4):291–294
Paick SH, Park HK, Oh SJ et al (2003) Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 62(2):214–217
Nevo A, Mano R, Schreter E et al (2017) Clinical implications of stent culture in patients with indwelling ureteral stents prior to ureteroscopy. J Urol 198(1):116–121
Nevo A, Golomb D, Lifshitz D et al (2019) Predicting the risk of sepsis and causative organisms following urinary stones removal using urinary versus stone and stent cultures. Eur J Clin Microbiol Infect Dis 38(7):1313–1318
Moses RA, Ghali FM, Pais VM et al (2016) Unplanned hospital return for infection following ureteroscopy—can we identify modifiable risk factors? J Urol 195(4 Pt 1):931–936
Yang L, Liu Y, Wu H et al (2012) Combating biofilms. FEMS Immunol Med Microbiol 65(2):146–157
Riedl CR, Plas E, Hübner WA et al (1999) Bacterial colonization of ureteral stents. Eur Urol 36(1):53–59
Kehinde EO, Rotimi VO, Al-Hunayan A et al (2004) Bacteriology of urinary tract infection associated with indwelling J ureteral stents. J Endourol 18(9):891–896
Sighinolfi MC, Sighinolfi GP, Galli E et al (2015) Chemical and mineralogical analysis of ureteral stent encrustation and associated risk factors. Urology 86(4):703–706
Klis R, Korczak-Kozakiewicz E, Denys A et al (2009) Relationship between urinary tract infection and self-retaining Double-J catheter colonization. J Endourol 23:1015
Funding
None.
Author information
Authors and Affiliations
Contributions
BS: collected data, wrote paper; MK: collected data; SI: wrote paper; OE: collected data; FP: collected data; BS: statistics; PS: collected data, reviewed paper.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Ethical approval
Not applicable.
Consent to participate
Not applicable.
Consent for publication
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Salari, B., Khalid, M., Ivan, S. et al. Urine versus stent cultures and clinical UTIs. Int Urol Nephrol 53, 2237–2242 (2021). https://doi.org/10.1007/s11255-021-02964-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-021-02964-x