CODE: 5 - Urinary tract infections and bacterial colonization of Double-J catheters
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Rafał Kliś ¹, Ewa Korczak-Kozakiewicz ², Waldemar Różański ¹

¹ I i II Klinika Urologii Katedry Urologii Uniwersytetu Medycznego w Łodzi
² Zakład Mikrobiologii Lekarskiej i Sanitarnej Katedry Mikrobiologii Uniwersytetu Medycznego w Łodzi

summary

Introduction. Ureteral Double-J stenting is a method facilitating the upper urinary tract drainage. Long-term ureteric stenting is associated with bacterial colonization of both stent surface and urine.

Objectives. The aim of the study was to evaluate the correlation between the type of bacteria cultured from the different Double-J catheter sections, removed from urinary tract, and the microorganisms cultured from urine. Relationship of positive Double-J catheter cultures with duration of D-J stenting was also evaluated.

Materials and methods. 42 patients, who had Double-J stents inserted, were enrolled into the study. They had their urine cultured prior to the stent insertion and again prior to the stent removal. The stent itself was immediately sent for culture, separately for the pelvical, ureteral and vesical section, and the culture was performed according to the obligatory microbiological standards. The obtained results were then analyzed, with the following points taken into account: correlation of Double-J stent colonization and bacteriuria, characteristics of the organisms the most frequently isolated from the urine and Double-J stents, and relationship of positive urine cultures with duration of D-J stenting.

Results. Urine cultures, obtained prior to the stent removal, were positive in 10 cases. In 32 cases the cultures were negative. Urine cultures were negative in all patients, who had their stents kept for less than 30 days. There were 25% positive urine cultures in case of stents maintenance longer than 30 days, but no longer than 90 days, and 45% in case of catheters kept for longer than 90 days. Of all 42 stents, only 1 was not colonized. In 41 cases the catheter cultures were positive, with different bacteria species. The most frequent pathogens colonizing Double-J stent were: Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, Staphylococcus haemolyticus. The organisms colonizing urine were: Escherichia coli, Staphylococcus epidermidis, Staphylococcus aureus.

Conclusions. 1. There is a relationship between the duration of Double-J stenting and urine culture. 2. Maintenance of Double-J catheter in the urinary tract is associated with a high risk for bacterial colonization. 3. Urine and respective Double-J stent sections are colonized by different bacteria species.