Epidemiology and risk factors for febrile ureteral stent-associated urinary tract infections: A prospective observational cohort study - 06/06/23
Summary |
Objectives |
We aimed to determine the incidence and risk factors of febrile ureteral stent-associated urinary tract infections (FUSAUTI).
Methods |
Hospitalized adult patients with ureteral stent (US) placement or exchange were prospectively enrolled. Patients with kidney transplantation of less than one year were excluded. Patients were followed until US removal/exchange or six months after inclusion.
Results |
Out of 663 patients included in the study, 48 had at least one FUSAUTI (cumulative incidence 7.24%; 95% confidence interval [CI] 5.39–9.48). The incidence rate of FUSAUTI was 9.04 (95% CI 6.67–12.2) per 10,000 US-days. Ten patients (20.8%) experienced sepsis or septic shock. The most frequently isolated microorganisms were Escherichia coli (38%), Enterococcus spp. (14.5%), Candida spp. (9%) and Pseudomonas aeruginosa (9%). In multivariable logistic regression analysis, female gender, an age adjusted Charlson comorbidity index score> 3, an urethral stent placement concomitant with US placement, and a history of urinary tract infection within three months were significantly associated with a higher risk of FUSAUTI.
Conclusion |
After US placement, 7.24% of patients developed at least one FUSAUTI and, in a quarter of cases, a serious infection. Urethral stent placement was the only modifiable risk factor identified. Future interventional studies are needed to reduce FUSAUTI in these patients.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Cumulative of incidence of febrile USAUTI was 7.24% [5.39–9.48]. |
• | Main microorganisms were E. coli, Enterococcus spp., Candida spp. and P. aeruginosa. |
• | The patient’s comorbidities are preponderant risk factors for febrile USAUTI. |
• | Urethral stent placement was the only modifiable risk factor identified. |
Keywords : Ureteral stent, Double-J stent, JJ stent, Urinary tract infection, Ureteral catheter, Healthcare-associated infection, Antibiotic therapy
Plan
Vol 87 - N° 1
P. 12-17 - juillet 2023 Retour au numéro
Article précédent
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