Do you recommend to exchange nephrostomy tubes when a patient is diagnosed with a urinary tract infection in the absence of any overt signs of infection at the exit site?
In particular, in individuals who are know to have their urinary tract colonized with an organism, and they will periodically develop a urinary tract infection, would you exchange the nephrostomy tube, even if they have already demonstrated continued growth of the organism despite switching out the tubes in the past?
2 Answers
Mednet Member
Infectious Disease · University of Miami Miller School of Medicine
Answered on
This patient has asymptomatic bacteriuria by definition - apparently with occasional symptomatic UTI. I would not change the tube because of the ASB like I would not change a urethral catheter in the setting of ASB. And as noted the patient has already demonstrated continued ASB after changing the tubes in the past. In the interest of antimicrobial stewardship and reducing the risk that the next UTI uropathogen will be even more resistant than it probably is now, reserve the microbiome blasters for the next time this patient expresses symptoms suggestive of UTI.
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Mednet Member
Infectious Disease · Ohio Health Physicians Group Infectious Disease
Answered on
No, unless blood cx pop positive.
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