Üreteral Stenti Olan Hastalarda Üriner Sistem Enfeksiyonu ve Predispozan Faktörler
Amaç: Double J stent (DJS) takılan hastaların idrar tahlili ve kültürünün anlamlı üriner enfeksiyon ile ilişkisini ortaya koymayı ve bu sayede gereksiz antibiyotik kullanımı ve fazladan tedavinin önüne geçmeyi planladık. Gereç ve Yöntemler: 2016 ile 2019 yılları arasında çeşitli sebeplerle DJS takılmış olan hastaların verileri retrospektif olarak incelendi. Bulgular: Çalışmaya toplam 152 hasta dahil edildi. Hastaların ortalama yaşı 48.9±14.9 yıl idi. DJS takılma endikasyonları: 108 (%71.2) hastada endoskopik üreter ve böbrek taşı tedavisi, 20 (%13.2) hastada perkütan nefrolitotomi ve 6 hastada renal transplantasyon idi. Hastaların yapılan idrar analizlerinde 8 hastada nitrit (+) bulunurken 117 hastada (%77) ise lökosit esteraz (+) idi. 20 hastanın (%13.2) idrar kültüründe çeşitli mikroorganizma üremeleri izlendi. Nitriti pozitif olan hastaların %75’inin idrar kültüründe üreme oldu. Ek hastalığı olanlar ile olmayanların idrar kültürlerinde mikroorganizma üreme açısından anlamlı farklılık saptanmadı (p= 0.132). Çok değişkenli regresyon analizinde yaş, cinsiyet, kateter kalış süresi, DJS konulma endikasyonundan hiçbirinin idrar yolu enfeksiyonu geliştirmeyi predikte etmediği görüldü (tüm değişkenler için p>0.05). Sonuç: Üreteral stenti olan hastalarda idrar tetkikinde nitrit pozitifliği üriner sistem enfeksiyonunu yüksek oranda predikte eder ve idrar kültürünü takiben uygun antibiyotik ile tedaviyi gerektirir.
Urinary Tract Infection and Predisposing Factors in Patients with Ureteral Stents
Objective: We aimed to demonstrate the relationship between urine analysis and culture of patients with DJ stents with significant urinary infection and thus prevent unnecessary antibiotic use and over-treatment. Material and Methods: The data of patients who had DJS insertion between 2016 and 2019 were investigated retrospectively. Results: A total of 152 patients were included in the study. The mean age of the patients was 48.9±14.9 years. Indications for DJS insertion were as follow: endoscopic ureter and kidney stone treatment was percutaneous nephrolithotomy in 108 (71.2%) patients, percutaneous nephrolithotomy in 20 (13.2%) patients and renal transplantation in 6 patients. The urine analysis of the patients revealed nitrite (+) in 8 patients and leukocyte esterase (+) in 117 patients (77%). In 20 patients (13.2%), various microorganism growths were observed in urine culture. 75% of patients with nitrite were positive in urine culture. No significant difference was found between urine cultures of patients with and without comorbidity (p = 0.132). In multivariate regression analysis, age, gender, catheter stay duration, and indications for DJS were not found top predict urinary tract infection (p> 0.05 for all variables). Conclusion: In patients with ureteral stent, nitrite positivity predicts urinary tract infection at a high rate and necessitate urine culture followed by appropriate antibiotic treatment.
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