Epidemiology and risk factors for febrile ureteral stent-associated urinary tract infections: a prospective observational cohort study
Abstract
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 factors identified. Future interventional studies are needed to reduce FUSAUTI in these patients.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 663 participants or records.
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