Correlation of Bacterial Colonisation with Time Duration in Indwelling Ureteral Double J Stents: A Prospective Observational Study

Introduction: Ureteral Double J (DJ) stents are commonly used in urology to ensure urinary drainage. However, prolonged indwelling time increases the risk of bacterial colonisation and biofilm formation, which can lead to infections and antibiotic resistance. Understanding the correlation between stent duration and microbial colonisation is crucial for optimising patient management and reducing complications. Aim: To evaluate the correlation between stent indwelling time and bacterial colonisation of ureteral DJ stents in patients with urologic indications. Materials and Methods: A prospective observational study was conducted from February 2024 to February 2025 on 70 patients who underwent DJ stenting for urological indications such as urolithiasis, ureteric stricture, pyelonephritis, or postoperative shunting in Department of Microbiology, Government Medical College and Department of Urology, Super-specialty Hospital, Nagpur, Maharashtra, India. The demographic profile of patients including age and gender were recoded and analysed for correlation with colonisation. The stents were aseptically removed after varying indwelling durations up to 12 weeks; Upper and lower segments of stent were cultured by roll plate method and flushing with trypticase soya broth on blood and MacConkey’s agar. Bacterial isolates were identified and subjected to antimicrobial susceptibility testing as per Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines. Biofilm formation was quantified using microtiter plate assay. Data were analysed using Statistical Package for the Social Sciences (SPSS) software and statistical significance was determined by the Chi-square test with p-value<0.05 considered significant. Results: Bacterial colonisation was found in 39 stents (55.71%). The predominant organism was Escherichia coli-14 (35.90%) isolates, followed by Klebsiella pneumoniae-8 (20.51%) isolates and Pseudomonas aeruginosa-7 (17.95%) isolates. Colonisation rates increased with stent duration: 3 (7.69%) at 0-2 weeks, 9 (23.08%) at 2-4 weeks and 17 (43.58%) at 4-6 weeks indicating a positive correlation between stent indwelling time and bacterial colonisation of ureteral DJ stents in patients with urologic indications. Biofilm formation was detected in 28 (71.79%) of isolates, with higher intensity in longer indwelling stents. Multidrug resistance was observed in 11 (28.21%) of isolates. Conclusion: Longer stent duration correlates with higher bacterial colonisation and biofilm formation. These findings highlight the need for timely stent removal and targeted antibiotic therapy to mitigate infection risk and resistance.