Urinary Infections in Patients with Catheters in the Upper Urinary Tract: Microbiological Study

Urol Int. 2017;98(4):442-448. doi: 10.1159/000467398. Epub 2017 Mar 30.

Abstract

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.

Keywords: Double-J stent; Healthcare-associated infections; Multiple-drug resistance; Nephrostomy tube; Urinary catheter.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheters*
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Enterococcus
  • Escherichia coli
  • Female
  • Humans
  • Immunocompromised Host
  • Immunosuppression Therapy
  • Klebsiella
  • Male
  • Middle Aged
  • Nephrostomy, Percutaneous
  • Nephrotomy
  • Prospective Studies
  • Pseudomonas
  • Risk Factors
  • Urinary Tract / microbiology
  • Urinary Tract Infections / microbiology*
  • beta-Lactamases / therapeutic use

Substances

  • beta-Lactamases