Introduction Minimally invasive pyeloplasty (MIP), namely, laparoscopic and robot-assisted interventions, has gained popularity in recent years. Double-J ureteral stents are frequently inserted during surgery. Foreign bodies in the urinary tract are considered as risk factor for developing urinary tract infection (UTI). This study aimed to specify the bacteria cultured from urine and stents responsible for UTI in children with indwelling ureteral stents undergoing MIP. Patients and Methods We retrospectively reviewed medical records of 30 children (22 boys and 8 girls) who had undergone MIP between 2014 and 2017. Median age at surgery was 2.7 years (interquartile range [IQR]: 0.5–7.9). Urine cultures were obtained before surgery, before stent removal, 1 month after stent removal, and if UTI was suspected. Stents were removed 4 to 8 weeks after surgery and cultured. Patients' demographics, types of stents, and surgical details were recorded. Results Median stent indwelling time was 5.09 weeks (IQR: 4–6). Postoperative febrile UTI developed in 4/30 (13%) patients. Afebrile UTI occurred in another 4/30 (13%) patients. Stent cultures were positive in 19/30 (63%) patients. Stent and urinary cultures were identical in only one patient. Three of four patients with preoperative asymptomatic bacteriuria developed postoperative UTI. There was no association between UTI, gender, stent diameter, and duration of indwelling catheter. Conclusion After MIP, febrile UTI and afebrile UTI occurred in about one quarter of patients. Pathogens isolated postsurgically from urinary cultures were unrelated to those colonizing the stents. Therefore, routine stent culturing is of low clinical significance. Moreover, small-caliber stents and longer indwelling periods were not risk factors for UTI. Optimizing antibiotic treatment for children with preoperative UTI may potentially prevent morbidity after surgery.

中文翻译：

---

接受微创肾盂成形术的儿童的输尿管支架定植和尿路感染

简介 微创肾盂成形术 (MIP)，即腹腔镜和机器人辅助干预，近年来越来越受欢迎。双 J 输尿管支架经常在手术期间插入。尿路中的异物被认为是发生尿路感染 (UTI) 的危险因素。本研究旨在明确从尿液和支架中培养的细菌，这些细菌是在接受 MIP 并留置输尿管支架的儿童中导致尿路感染的原因。患者和方法 我们回顾了 2014 年至 2017 年间接受过 MIP 的 30 名儿童（22 名男孩和 8 名女孩）的医疗记录。手术时的中位年龄为 2.7 岁（四分位间距 [IQR]：0.5-7.9）。在手术前、支架取出前、支架取出后 1 个月以及怀疑 UTI 时进行尿液培养。术后 4 至 8 周取出支架并进行培养。记录了患者的人口统计资料、支架类型和手术细节。结果 中位支架留置时间为 5.09 周 (IQR：4–6)。4/30 (13%) 患者发生术后发热性 UTI。另有 4/30 (13%) 患者发生非发热性 UTI。19/30 (63%) 患者的支架培养呈阳性。只有一名患者的支架和尿液培养是相同的。术前无症状菌尿的 4 名患者中有 3 名发生了术后尿路感染。UTI、性别、支架直径和留置导管的持续时间之间没有关联。结论 MIP后约四分之一的患者出现发热性UTI和非发热性UTI。术后从尿液培养物中分离出的病原体与在支架上定殖的病原体无关。所以，常规支架培养临床意义不大。此外，小口径支架和较长的留置时间不是 UTI 的危险因素。优化术前 UTI 患儿的抗生素治疗可能会预防术后并发症。