Incidence of Percutaneous Nephrostomy Tube-Associated Urinary Tract Infections in Vajira Hospital Percutaneous Nephrostomy Tube-Associated Infections
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Abstract
OBJECTIVE: To study the incidence of percutaneous nephrostomy tube-associated urinary tract infection (PCNI), changes in urinary characteristics, and factors associated with PCNI.
METHODS: A chart review was performed to retrospectively collect data on patients who underwent percutaneous nephrostomy (PCN) insertion for the first time. The eligibility criteria were met by 103 patients. PCNI incidence and correlation, changes in urinary characteristics and infectious events following insertion, bacterial characteristics, and the relationship between the type of bacteria and the presence of symptoms were all investigated.
RESULTS: The incidences of PCNI, sepsis, pyuria, and bacteriuria after insertion were 25.2%, 14.5%, 61.1%, and 48.5% within 76, 67, 25, and 46 days, respectively. The most common bacteria were multi-drug-resistant Escherichia coli (MDR E. coli) (16.2%), Pseudomonas aeruginosa (P. aeruginosa) (11.7%), Escherichia coli (E. coli) (10.3%), and Enterococcus faecalis (E. faecalis) (10.3%), which were susceptible to carbapenem, piperacillin/tazobactam, and amikacin. The bacterial type and PCNI demonstrated no correlation. However, the frequency of PCN change, indwelling period, pyuria, and bacteriuria in chronic kidney disease was significantly correlated with PCNI (p < 0.05).
CONCLUSION: Quarter of patients with a PCN catheter develops PCNI. More than half of patients with PCN indwellers had pyuria or bacteriuria. E. coli has the most significant ratio. Carbapenem, piperacillin/tazobactam, and amikacin all had benefits but should be adjusted in terms of culture results, especially in the multi-drug resistance group. The incidence of PCNI may decrease with early diagnosis, drainage, and the shortest period before specific treatment in the future.
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