The risk of bacteriuria and ureteric stent colonization in immune-compromised patients with double J stent insertion

To evaluate the influence of diabetes mellitus (DM), chronic renal failure (CRF), and malignancies on the rate of bacteriuria and double J ureteric stent bacterial colonization.

One hundred and twenty patients were included in this prospective study. Midstream urine samples for culture were obtained before ureteric stent insertion. Patients with negative culture were given ciprofloxacin 500 mg orally q 12 h for 5 days as a prophylaxis. All the stents were removed or changed as indicated after having voided midstream urine sample for culture on the day of stent removal. Stents were sent for culture. Culture was obtained from the outer surface of the stent by gentle scraping with a sterile scalpel. Significant bacteriuria was defined as a count of colony-forming units per milliliter of urine of >10(5).

The patients were between 20 and 74 years of age (mean 42.5 + or - 13) and the duration of stent insertion ranged between 14 and 120 days (52.5 + or - 7.2). In 29 patients (24.2%), double J stent bacterial colonization was positive (12 males and 17 females). Of these patients, 27 (22.5%) had positive urine cultures (11 males and 16 females). The most commonly isolated pathogen was Escherichia coli. DM, CRF, or malignancies showed a higher risk for bacteriuria and stent bacterial colonization.

Immune-compromising diseases such as DM, CRF, and malignancies are proved to be risk factors for urinary tract infection and stent colonization in patients with ureteric stent insertion. Stent cultures are not needed as the same microorganisms grow in urine cultures.