Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent aft
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ORIGINAL ARTICLE
Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy Guo Jiang 1 & Jiang Li 1 & He Long 2 & Chen Qiulin 2 & Ren Jin 2 & Yang Yaodong 2 & Dong Xingyou 2 & Zhao Jiang 2 & Zhang Zhenyang 2 Received: 7 January 2020 / Accepted: 24 September 2020 # The Author(s) 2020
Abstract The purpose of this study is to explore the risk factors, bacterial species, and drug resistance of acute pyelonephritis (AP) associated with ureteral stent after percutaneous nephrolithotomy (PCNL) and to provide reference for clinical intervention. The clinical data of 415 patients with indwelling ureteral stent after PCNL from December 2016 to May 2019 were analyzed retrospectively. The patients were divided into infection group (n = 54) and non-infection group (n = 361) according to whether patients had AP. Patients’ clinical data, blood and urine bacterial culture, and drug sensitivity were collected and analyzed. The incidence of AP associated with ureteral stent after PCNL was 13.01% and diabetes mellitus (P = 0.001), postoperative stone residue (P = 0.002), urinary leucocytes ≥ 100/HP (P = 0.018), positive urine culture results (P = 0.001), ureteral stent retention time ≥ 8 weeks (P = 0.004), and high S.T.O.N.E. score (P = 0.014) are independent risk factors for it. Escherichia coli (40.54%, 47.82%), Klebsiella pneumoniae (16.21%, 15.21%), Pseudomonas aeruginosa (10.81%, 4.34%), Enterococcus faecalis (21.6%, 19.56%), and epidermis Staphylococci (10.81%, 13.33%) are the main pathogens in blood and urine. The main sensitive drugs of pathogenic bacteria are imipenem, meropenem, tigecycline, piperacillin/tazobactam, ceftazidime, linezolid, teicoplanin, levofloxacin, vancomycin, tigecycline, etc., while levofloxacin, norfloxacin, penicillin G, first, and second-generation cephalosporins showed a strong drug resistance rate (> 70%). This study found that diabetes, postoperative stone residuals, urinary leukocytes ≧ 100 cells/HP, positive urine culture results, ureteral stent indwelling time ≧ 8 weeks, and high S.T.O.N.E. score were independent of AP associated with ureteral stent after PCNL risk factors and Escherichia coli is the main pathogenic bacteria and shows drug resistance. Keywords Percutaneous nephrolithotomy . Ureteral stent . Acute pyelonephritis . Infection . Bacterial strain . Drug sensitivity . Drug resistance
Introduction Kidney stones are a common and frequently occurring disease of the urinary system. The incidence is 10.34% in men and 6.62% in women [1]. Percutaneous nephrolithotomy (PCNL) is the main treatment method for kidney stones [2, 3]. PCNL
* Zhang Zhenyang [email protected] 1
Department of Urology, Anyue People’s Hospital of Ziyang City, Sichuan Province, Ziyang 642300, China
2
Department of Urology, Chongqing Hechuan Hongren Hospital, Chongqing 401520, China
has been used as an important minimally invasive method for the treatment of kidney stones because of its small trauma and rapid rec
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