Characteristics of Bacterial Colonization and Urinary Tract Infection after Indwelling of Double-J ureteral Stent and Percutaneous Nephrostomy Tube

Abstract

Introduction: Infections associated with catheter in the upper urinary tract (CUUT), which include the double-J stent and the percutaneous nephrostomy (PCN) tube, get particularly infected in patients with specific risk factors for developing an infection. Methods: A retrospective observational study was carried out by compiling data from the hospital information system of a tertiary care center from 2019 to 2021 to evaluate infections in patients with catheter in the upper urinary tract. Result: A total of 200 pus samples of double-J stent (96 pus samples) and PCN tube (104 pus samples) were included in our study. Among patients with nephrostomy tube, the most frequently isolated microorganisms were Escherichia coli, followed by Pseudomonas spp. In those with a double-J stent, Pseudomonas aeruginosa, followed by E. coli were the most commonly isolated microorganisms. We found 55.72% of cases of Enterobacteriaceae-producing carbapenemases in patients with a percutaneous catheter. 66.07% of Enterobacteriaceae in patients with double-J and nephrostomy stents are extended-spectrum beta-lactamase-producing bacteria. The percentage of cultures with multiple-drug resistance (MDR) microorganisms was 38.54% in patients with double-J stents and 37.75% in nephrostomy tubes. The presence of prior urinary tract infection (P = 0.010), presence of urinary catheter before admission (P = 0.005), increased time with single urinary catheter in-situ (P < 0.001), and increased length of hospital stay (P = 0.036) were risk factors for isolation of MDR microorganisms. Conclusion: Pseudomonas spp. and Pseudomonas aeruginosa are commonly infecting both the CUUT. E. coli infections are more commonly infecting the nephrostomy tubes. MDR microorganisms are frequent, mainly in patients with prior urinary tract infection, presence of urinary catheter before admission, and prolonged use of a single catheter.

Analysis of Characteristics, Pathogens and Drug Resistance of Urinary Tract Infection Associated with Long-Term Indwelling Double-J Stent

“…Previous studies have suggested that the pathogens of double-J stent-related infections mainly include Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis and Klebsiella pneumoniae . 12 , 21 , 28 In this study, we found that under the condition of double-J stent associated urinary tract infection, the pathogenic bacteria culture rate of double-J stent was significantly higher than that of urine (67.65% vs 35.29%). In addition, we also found that the main pathogenic bacteria in the urine were Escherichia coli (30.55%) from Gram negative bacteria, while the main pathogenic bacteria in double-J stent were Enterococcus faecalis from Gram positive bacteria (27.53%).…”

“…[8][9][10] Previous studies have shown that long-term indwelling of double-J stent is an important risk factor for recurrent urinary tract infection. 21 In addition, the increase of double-J stent retention time significantly increases the risk of gross hematuria, pain, bladder irritation, urinary tract infection and fever. 22 However, there are few reports on the etiology of urinary tract infection caused by long-term (1-3 months) double-J stent indwelling, as well as the characteristics of pathogenic bacteria and drug resistance in urine and double-J stent.…”

Comparison of In-vitro Activity of Cefixime to Doxycycline and Minocycline Against Gram-Negative Bacteria Isolated from Patients Suffering from Respiratory Tract Infections at a Tertiary Care Centre in Northern India

“…As observed in Table 3, among the 100 MDR microorganisms tested for susceptibility to the antibiotics, the overall susceptibility to Doxycycline was 35% (35/100, 35%), which was significantly higher in comparison to the overall susceptibility of Cefixime (17/100, 17%) which is in contrast to a study conducted by Ramdhani et al [1] where the test isolates were found to demonstrate better susceptibility to Tetracyclines. Tetracycline is a bacteriostatic agent that was found to be more effective in treating the infections caused by the bacterial isolates in our study cohort due to extensive Beta-lactam resistance that has been observed in isolates identified from other infections in studies conducted at our center [26].…”