Colonizations on biofilm layers of d-j catheters under sterile urine conditions

Objetive: To evaluate colonizations on biofilm layers of Double J (D-J) catheters implanted for kidney stones or ureteral stones under sterile conditions. Methods: -J catheters implanted between January 2012 and February 2014 and removed in 0-90 days, were examined in microbiology laboratory prospectively. Fifty two patients divided into three groups regarding the duration of the D-J catheters as; 0-30 days, 31-60 days, 61-90 days. The colonization (≥1.000 colony) was reported after biofilm layer on D-J catheter was hold in culture media. The upper, middle and lower parts of the catheters were analyzed seperately. Results:Thirty five patients had symptomatic urinary tract infection or positive urine culture after implantation were excluded from the study. Colonization on biofilm layer was detected in 11 patients (21.15%) [Coagulase-negative staphylococci (CNS): 3, Escherichia coli (E. coli): 3, Candida species (Candida spp.): 3, Klebsiella species (Klebsiella spp.): 2]. The rates of colonization according to the duration of the catheterization were; 12.5% in 0-30 days, 18.51% in 30-60 days, 29.4% in 60-90 days (Group 1 vs 2; p=0.696 , group 1 vs group 3; p=0.356 , group 2 vs group 3; p=0.401). The rates of colonization according to the location of the catheter were; 100% in upper and lower parts, 54.4% in middle part (Group 1 vs 2; p=0.011, group 1 vs group 3; p=1, group 2 vs group 3; p=0.011). Conclusions: Colonization on catheters is possible even in the sterile urinary conditions according to the present findings. The risk of colonization increases 1.5 times in 30-60 days and 2.5 times in 60-90 days compared to the first 30 days. Besides the risk of colonization increases about 2 times in the convoluted edges of the catheter compared with the middle part. Thus, D-J catheter should be removed as soon as possible and the risk of colonization should be minimalized