Recommendations of the AFU Infectious Diseases Committee on the prevention, diagnosis and treatment of infections of endo-ureteral equipment

Bey, E.; Bouiller, Kévin; Pimpie, Romain; Goux, C.; Tourret-Arnaud, Jérome; Lina, Gérard; Figueiredo, Samy; Chauvin, Anthony; Gavazzi, G.; Malavaud, S.; Sotto, Albert; Vallée, M.; Bruyère, F.

doi:10.1016/j.purol.2021.02.005

Cited by 8 publications

(6 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Altunal et al reported similar results (35). In addition, previous systematic reviews have reported that Staphylococcus, E. coli, Klebsiella species, P. aeruginosa, Enterococcus, and Candida species were the microorganisms most commonly identified in urine or ureteral stents (16,17).…”

Section: Discussionmentioning

confidence: 81%

“…Therefore, severely impaired renal function (in particular CKD state 4 and 5) may result in both concentrated bacteria and subsequent development of symptomatic UTI which is consistent with our results. In previous literature reviews (16,17), CKD appeared to be associated with an increased colonization rate of ureteral stents without any clear evidence of an increase in the development of UTI, although the methodological quality of the included studies was inadequate to derive any clear conclusions. It is known that fewer virulence factors are required for infection in patients with ureteral stents than in those with good function of the urinary tract.…”

Section: Discussionmentioning

confidence: 97%

“…coli , Klebsiella species, P . aeruginosa , Enterococcus , and Candida species were the microorganisms most commonly identified in urine or ureteral stents ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…They examined 65 patients, a small population compared with our study’s relatively larger population (307 patients). Additionally, recent literature reviews demonstrated that a longer duration of ureteral stenting was an associated risk factor for the occurrence of bacteriuria, although the included studies presented multiple methodological biases ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, only a few studies have assessed the pathophysiology and risk factors for the development of symptomatic UTI in these patients. Recently, two literature reviews have attempted to clarify the epidemiological characteristics and risk factors for UTI in patients with ureteral stents; however, they could not come to clear conclusions due to discrepancies in methodology and a low level of evidence of the included studies ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Determination of microbiological characteristics and risk factors associated with bacteriuria and symptomatic urinary tract infection in patients with retained ureteral stents: an observational study

Kim¹,

Yeo²,

Park³

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

Background: The maintenance of ureteral stents is vital in patients with severe ureteral stricture or ureteral obstruction. This study aimed to identify microbiological characteristics and factors associated with bacteriuria and symptomatic urinary tract infection (UTI) in these patients.Methods: This study is an observational cross-sectional study. From August 2018 to January 2021, urine samples from 307 consecutive patients who required stent indwelling and had replaced ureteral stents more than once were collected before the replacement procedure and analyzed by microbiological testing. Patient demographics, laboratory test results, and data on dependent functional capacity and indwelling urethral catheter use were collected from all patients. Additionally, ureteral stenting duration and number of previous ureteral stent replacements were reviewed. The primary endpoint was the incidence rate of bacteriuria and extended-spectrum beta-lactamase (ESBL)-producing bacteria. The secondary endpoint was the factors predisposing patients with ureteral stents to bacteriuria, ESBL-producing bacteria, and the development of symptomatic UTIs.Results: Bacteriuria was observed in 187 patients (60.9%). Among the bacteria identified in urine, Escherichia coli was the most commonly isolated microorganism, followed by Enterococcus, Candida species, Staphylococcus species, Klebsiella, and Pseudomonas. Using multivariate analysis, bacteriuria was significantly associated with old age, female sex, presence of diabetes mellitus, impaired renal function, and longer duration of ureteral stenting. ESBL-producing bacteria were detected in 52 isolates (27.8%). The incidence of ESBL-producing bacteria in urine culture was associated with old age and longer ureteral stenting duration. Additionally, symptomatic UTIs developed in 22 patients (7.2%). Dependent functional capacity, impaired renal function, and longer ureteral stenting duration were significantly associated with symptomatic UTIs.Conclusions: Infections related to ureteral stents showed a specific microorganism profile and resistance pattern compared to community-acquired UTIs. Additionally, we identified the factors associated with bacteriuria and symptomatic UTI in patients with retained ureteral stents and deduced that these may be associated with better outcomes in patients with retained ureteral stents.

show abstract

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 97%

“…coli , Klebsiella species, P . aeruginosa , Enterococcus , and Candida species were the microorganisms most commonly identified in urine or ureteral stents ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations