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Published on: December 31, 2017
Microbial Colonization Pattern of Indwelling Double J Stents in Children
Sandeep Nishanth1, Ramesh Babu1, Sathyamurthy Arunaa1
1Department of Paediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Insights
Urinary tract infections (UTIs) are a risk with double-J stents in children. However, stent colonization in pediatric patients often remains asymptomatic and does not lead to active UTIs.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Microbiology
Background:
- Indwelling double-J stents (DJ stents) are commonly used after urological procedures.
- These stents can harbor polymicrobial biofilms, increasing the risk of urinary tract infections (UTIs).
Purpose of the Study:
- To investigate the incidence and microbiological characteristics of DJ stent-associated UTIs in pediatric patients.
- To understand the clinical significance of stent colonization in this population.
Main Methods:
- Urine samples and DJ stents were collected from pediatric patients (<18 years) undergoing stent removal.
- Stent cultures were performed, and antibiograms were generated for identified organisms.
- Patients' clinical status regarding UTI symptoms was monitored.
Main Results:
- Stent colonization was observed in 29.6% of pediatric patients, with E. coli being the most common organism.
- The majority of colonized patients were asymptomatic, and colonization did not result in active UTIs.
- Organisms showed sensitivity to specific antibiotics like Cephaerazone/Sulbactam and Amikacin.
Conclusions:
- Microbial colonization of DJ stents is common in pediatric patients but frequently asymptomatic.
- Knowledge of culture and sensitivity patterns is crucial for targeted antibiotic use during stent removal.
Background:
Indwelling double-J-stent (DJ stent) kept post-urological procedures may cause urinary tract infections (UTIs) due to polymicrobial biofilm formation and colonisation.
Aims:
To determine the incidence and microbiological characteristics of DJ stent related UTIs in a paediatric population.
Methods And Material:
Patients under the age of 18 admitted for DJ stent removal following pediatric urological procedures were enrolled into the study. Prior to surgical removal of the DJ stent, a urine sample was collected and the stent was cystoscopically removed under anesthesia. The ends of the stent were inoculated into culture media and incubated up to 48 hours. When growth was observed, an antibiogram was obtained using a panel of anti-microbial agents.
Results:
The study group consisted of 27 patients (M: F = 23:4) with a mean age of 4.3 years (1 month - 13 years). The commonest indication for stent placement was Pyeloplasty, 19 (70%). Stent colonisation was found in 8 out of 27 patients (29.6%; CI 12-51%) and E.Coli (33%) was the commonest organism. Polymicrobial growth was noted in 4 patients. Organisms were sensitive to Cephaerazone/ Sulbactam and Amikacin, and resistant to other Cephalosporins. All 8 culture positive patients were asymptomatic and a repeat urine culture revealed no growth. Colonisation did not lead to active UTI and post stent removal the urine became sterile.
Conclusions:
Microbial colonisation was noted in 30% of patients with indwelling DJ stents. Prior knowledge of culture & sensitivity pattern helps to cover the patients with appropriate antibiotic on the day of stent removal.
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