Rahman M A, Alam M M, Shahjamal S, Islam M R, Haque M E
Urology, National Institute of Kidney Diseases and Urology, Sher-e-Bangla Nagar, Dhaka, Bangladesh. drafzal29@ yahoo.co.uk
Mymensingh Med J. 2012 Apr;21(2):300-5.
To evaluate the predictive value of urine cultures in the assessment of ureteral stent colonization and to investigate the frequency of double J stent colonization and stent associated bacteriuria. This observational study was conducted in the department of Urology, Dhaka Medical College Hospital from December 2006 to March 2009. A total of 100 patients (mean age 39.2 ± 9.9 years, range 18-60 years, 69 male and 31 female) needing internal ureteral stent placement for different sorts of urinary tract operations were included in the study. Sterile urine samples were obtained from each patient before stenting and all patients had been given short-term prophylactic antibiotic (5-12 days). On the day of stent removal midstream urine were obtained from all patients for microbiological culture. Stents removed by aseptic precaution. Proximal and distal tip segments (3-5 cm) were also sent for culture. The lowest and highest durations of stenting were 10 and 86 days respectively (median 35 days). Both bacteriuria and bacterial colonization was significantly higher as duration of stenting increases (p=0.045 and p<0.001). E. coli was the most common microorganism isolated from both urine and stent culture. However, colonization rate of stents was much higher (45%) than positive urine cultures (21%) indicating that urine culture is less sensitive to diagnose stent colonization (k-value = 0.49). The study concludes that bacterial colonization significantly increases with indwelling time of stent and sterile culture of urine does not rule out that the stent itself is colonized.
评估尿培养在输尿管支架定植评估中的预测价值，并调查双J支架定植及支架相关菌尿的发生率。本观察性研究于2006年12月至2009年3月在达卡医学院医院泌尿外科进行。共有100例因各种尿路手术需要置入输尿管内支架的患者纳入研究（平均年龄39.2±9.9岁，范围18 - 60岁，男性69例，女性31例）。在置入支架前从每位患者获取无菌尿样，所有患者均接受了短期预防性抗生素治疗（5 - 12天）。在取出支架当天，从所有患者获取中段尿进行微生物培养。通过无菌操作取出支架。支架的近端和远端尖端部分（3 - 5厘米）也送去培养。支架置入的最短和最长时间分别为10天和86天（中位数35天）。随着支架置入时间的增加，菌尿和细菌定植均显著增加（p = 0.045和p < 0.001）。大肠杆菌是从尿培养和支架培养中分离出的最常见微生物。然而，支架的定植率（45%）远高于阳性尿培养率（21%），这表明尿培养对诊断支架定植的敏感性较低（k值 = 0.49）。该研究得出结论，细菌定植随着支架留置时间显著增加，尿的无菌培养不能排除支架本身已被定植。
