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Urinary Infections in Patients with Catheters in the Upper Urinary Tract: Microbiological Study
Alba Lara-Isla1, José Medina-Polo, Manuel Alonso-Isa
1Department of Urology, Hospital Universitario 12 de Octubre and Madrid Complutense University, Madrid, Spain.
Background:
Infections related to catheters in the upper urinary tract (CUUT) are associated with specific characteristics.
Methods:
A prospective observational study was carried out from 2012 to 2015 to evaluate infections in patients with CUUT.
Results:
A total of 209 infections were included (99 with double-J, 81 with nephrostomy, and 29 with internal/external nephroureteral stents). Among nephrostomy tube carriers, the most frequently isolated microorganisms were Pseudomonas and Enterococcus. In those with an internal/external nephroureteral stent, Klebsiella was the most common, and 57.1% were extended-spectrum beta-lactamase-producing Klebsiella. In double-J carriers, Escherichia coli and Enterococcus were the most common microorganisms. Multiple-drug resistance (MDR) microorganisms were isolated in 28.6, 47.1, and 58.3% of patients with double-J, nephrostomy, and internal-external nephroureteral stents. A percutaneous CUUT (p = 0.005) and immunosuppression (p = 0.034) were risk factors for MDR microorganisms.
Conclusions:
Non-E. coli bacteria are commonly isolated in patients with CUUT. MDR microorganisms are frequent, mainly in percutaneous approach or immunosuppression.