Mainali Prakash, Luitel Prajjwol, Paudel Sujan, Thapaliya Ishwor, Sharma Uttam Kumar, Chapagain Suman, Gautam Pratima, Luitel Bhoj Raj, Chalise Pawan Raj
Department of General Surgery, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital.
Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Ann Med Surg (Lond). 2024 Oct 23;86(12):7023-7028. doi: 10.1097/MS9.0000000000002683. eCollection 2024 Dec.
The increasing use of double J ureteral stents (DJS) has increased the risk of early intolerance and long-term complications. Studies have reported stent colonization rates ranging from 19 to 90% with various bacterial profiles in the colonization of stents.
To identify the risk factors associated with bacterial colonization of DJS and report the common micro-organisms isolated and drug susceptibility pattern.
This study is a prospective study of patients who underwent DJS. A total of 48 patients from our institution were studied between March 2022 and August 2023. After the removal of DJS with a sterile technique, the tips of both ends (renal end and bladder end) of the stent were cut and processed in the microbiology lab.
Bacterial colonies were detected in 56.25% (27 out of 48) of the stents. Among the pathogens identified, species, and were the most frequently isolated. The colonization rate increased with the duration of stent placement and albuminuria.
The study indicated that prolonged indwelling time and albuminuria are a risk factor for bacterial colonization on the stent therefore, it is advisable to use double J ureteral stent only when absolutely necessary and to remove them promptly.
双J输尿管支架（DJS）使用的增加提高了早期不耐受和长期并发症的风险。研究报告称，支架定植率在19%至90%之间，支架定植中的细菌谱各不相同。
确定与DJS细菌定植相关的风险因素，并报告分离出的常见微生物及药敏模式。
本研究是一项对接受DJS治疗患者的前瞻性研究。2022年3月至2023年8月期间，对我院的48例患者进行了研究。采用无菌技术取出DJS后，将支架两端（肾端和膀胱端）的尖端剪下并在微生物实验室进行处理。
56.25%（48例中的27例）的支架检测到细菌菌落。在鉴定出的病原体中，[具体菌种1]、[具体菌种2]和[具体菌种3]是最常分离出的。定植率随支架置入时间和蛋白尿的增加而升高。
该研究表明，留置时间延长和蛋白尿是支架细菌定植的危险因素，因此，仅在绝对必要时使用双J输尿管支架，并应及时取出。
