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TH
CONGRESS OF THE ESPU
S23-9 (P without presentation)
IS BACTERIAL COLONIZATION OF URETERAL
DOUBLE-J STENTS SIGNIFICANT AND PREDICTABLE
IN CHILDREN WITH URETERAL STONES?
Cem AKBAL
1
, Yiloren TANIDIR
1
, Farhad TALIBZADE
1
, Cagri Akin SEKERCI
1
,
Arzu ILKI
2
, Eda KEPENEKLI KADAYIFCI
3
, Ibrahim GOKCE
4
and Ferruh SIMSEK
1
1) Marmara University School of Medicine, Urology, Istanbul, TURKEY - 2) Marmara University School of Medicine,
Microbiology, Istanbul, TURKEY - 3) Marmara University School of Medicine, Pediatrics, Pediatric Infectious Disease
Division, Istanbul, TURKEY - 4) Marmara University School of Medicine, Pediatrics, Pediatric Nephrology Division,
Istanbul, TURKEY
PURPOSE
Aim of this study is to evaluate of bacterial colonization on double-j ureteral stents (DJUS) and find
out the reliability of urine tests to detect it.
MATERIAL AND METHODS
Forty children who had undergone endoscopic urinary stone surgery with DJUS placement between
2012 and 2016 were included. All DJUS removals were done following negative urine cultures. In
case of refractory urinary tract infection, DJUS removals were done under broad-spectrum antibiotic
treatment. All stents were gone under microbiological evaluation. DJUS culture results were com-
pared with three findings in urine analysis: 1- presence of pyuria (having more than 5 leukocyte per
HPF), 2- nitrite positivity, 3- leukocyte esterase positivity.
RESULTS
A total of 19 males and 21 females, with mean age of 6.78 ± 4.65 years, were evaluated. Bacterial
colonization was detected in 42.5% (n=17) of the DJUSs. Single bacteria was detected in 5 of
them. The most common isolated microorganism was Enteroccus spp.(n=6);E.faecalis(n:4) and
E.faeciaum(n:2). Almost all isolated microorganisms were sensitive to gentamicin and ampicillin.
Mixed growth was detected from three of the cultures. Six of the DJUSs were suspected to be con-
taminated with skin flora (MRSA (n=1), Diphtheroids (n=1), Coagulase Negative Staphylococcus
(n=1), C. albicans (n=1), Bacillus spp (n=1), and antibiotic susceptibility was not assessed to them) .
Mean DJUS indwelling time in colonized and non-colonized stents were 43.52 ± 15.48 days and
47.91 ± 23.03 days (p=0.50). All three subdomains of urine analysis were insufficient to predict
DJUS contamination prior to removal (p>0.05). Two patients, one with DJUS colonization, were
hospitalized for severe UTI after stent removal.
CONCLUSIONS
Negative urine cultures cannot rule out stent colonization. DJUS culture evaluation is a must in
every stent removal in pediatric age group. In case of stent related infections best empirical treat-
ment is suggested as Gentamicin and/or Ampicillin.