Bacterial Colonization of Ureteral Double-J Stents in Patients with Negative Urine Culture

Abstract

Objective: Ureteral double-J stents are extensively used in urology practice. We aimed to investigate the bacterial colonization rate and predominant microorganisms on ureteral double-J stents in patients with negative urine cultures in a prospective study. Materials and Methods: A total of 35 double-J ureteral stents from 35 consecutive patients were examined. The cyctoscopically removed stents were divided into three parts as upper, middle and lower then sent for the microbiologic examination with a urine sample just taken before stent removal. The samples were inoculated on sheep blood agar and eosin-methylene blue agar culture mediums. The growth of >1000 colony-forming units/mL was considered significant. The antimicrobial susceptibility test was performed with 10 broad spectrum antibiotics. Results: Bacterial colonies were found in 20% of 35 ureteral stents. The most frequently isolated bacteria was Staphylococcus epidermidis, followed by Escherischia coli and Enterococcus faecalis. Bacterial colonization was revealed in all parts of the stents in 71.4% cases. The stent indwelling time was correlated with stent culture positivity (p=0.035). However, no correlation was detected with gender, age and stent colonization (p=0.05). Conclusion: Negative urine culture result does not always rule out positive stent culture. Even not routinelly recommended, stent culture could be useful for treatment of a possible postoperative urinary tract infection and sepsis in high risk patients who undergo endourologic surgery.