Improved detection of microbial ureteral stent colonisation by sonication

Area of Science:

• Urology
• Infectious Diseases
• Medical Microbiology

Background:

• Microbial ureteral stent colonization (MUSC) diagnosis is challenging due to biofilm-embedded microorganisms.
• Conventional diagnostic methods lack accuracy in detecting MUSC.
• Novel diagnostic approaches are needed to improve yield and understand MUSC pathophysiology.

Purpose of the Study:

• To evaluate sonication's potential for detecting MUSC.
• To identify risk factors associated with ureteral stent colonization.

Main Methods:

• Prospective evaluation of 408 polyurethane ureteral stents from 300 patients.
• Conventional urine culture (CUC) and sonication performed for microorganism detection.
• Patient data including sex, age, indwelling time, and indication for stent placement were recorded.

Main Results:

• Sonication detected MUSC in 36% of stents.
• Stents inserted during urinary tract infection (UTI) showed higher colonization rates (59%) versus sterile placements (26%).
• Significant risk factors for MUSC included female sex, continuous stenting, and longer indwelling times. Common isolates were Coagulase-negative staphylococci, Enterococci, and Enterobacteriaceae.

Conclusions:

• Sonication shows promise for diagnosing MUSC.
• UTI at insertion, female sex, continuous stenting, and indwelling time are significant MUSC risk factors.
• CUC is an unreliable indicator of MUSC; clinical relevance requires further study.