Improved detection of microbial ureteral stent colonisation by sonication

Purpose: The diagnosis of microbial ureteral stent colonisation (MUSC) is difficult, since routine diagnostic techniques do not accurately detect microorganisms embedded in biofilms. New methods may improve diagnostic yield and understanding the pathophysiology of MUSC. The aim of the present study was to evaluate the potential of sonication in the detection of MUSC and to identify risk factors for device colonisation. Methods: Four hundred and eight polyurethane ureteral stents of 300 consecutive patients were prospectively evaluated. Conventional urine culture (CUC) was obtained prior to stent placement and device removal. Sonication was performed to dislodge adherent microorganisms. Data of patient sex and age, indwelling time and indication for stent placement were recorded. Results: Sonicate-fluid culture detected MUSC in 36%. Ureteral stents inserted during urinary tract infection (UTI) were more frequently colonised (59%) compared to those placed in sterile urine (26%; P<0.001). Female sex (P<0.001) and continuous stenting (P<0.005) were significant risk factors for MUSC; a similar trend was observed in patients older than 50years (P=0.16). MUSC and indwelling time were positively correlated (P<0.005). MUSC was accompanied by positive CUC in 36%. Most commonly isolated microorganisms were Coagulase-negative staphylococci (18.3%), Enterococci (17.9%) and Enterobacteriaceae (16.9%). Conclusions: Sonication is a promising approach in the diagnosis of MUSC. Significant risk factors for MUSC are UTI at the time of stent insertion, female sex, continuous stenting and indwelling time. CUC is a poor predictor of MUSC. The clinical relevance of MUSC needs further evaluation to classify isolated microorganism properly as contaminants or pathogen

Improved detection of microbial ureteral stent colonisation by sonication

Purpose: The diagnosis of microbial ureteral stent colonisation (MUSC) is difficult, since routine diagnostic techniques do not accurately detect microorganisms embedded in biofilms. New methods may improve diagnostic yield and understanding the pathophysiology of MUSC. The aim of the present study was to evaluate the potential of sonication in the detection of MUSC and to identify risk factors for device colonisation. Methods: Four hundred and eight polyurethane ureteral stents of 300 consecutive patients were prospectively evaluated. Conventional urine culture (CUC) was obtained prior to stent placement and device removal. Sonication was performed to dislodge adherent microorganisms. Data of patient sex and age, indwelling time and indication for stent placement were recorded. Results: Sonicate-fluid culture detected MUSC in 36%. Ureteral stents inserted during urinary tract infection (UTI) were more frequently colonised (59%) compared to those placed in sterile urine (26%; P<0.001). Female sex (P<0.001) and continuous stenting (P<0.005) were significant risk factors for MUSC; a similar trend was observed in patients older than 50years (P=0.16). MUSC and indwelling time were positively correlated (P<0.005). MUSC was accompanied by positive CUC in 36%. Most commonly isolated microorganisms were Coagulase-negative staphylococci (18.3%), Enterococci (17.9%) and Enterobacteriaceae (16.9%). Conclusions: Sonication is a promising approach in the diagnosis of MUSC. Significant risk factors for MUSC are UTI at the time of stent insertion, female sex, continuous stenting and indwelling time. CUC is a poor predictor of MUSC. The clinical relevance of MUSC needs further evaluation to classify isolated microorganism properly as contaminants or pathogen

Wissenschaftliche Grundlagen zum Strategiediskurs für einen nachhaltigen Pflanzenbau

Für den rationalen gesellschaftlichen Diskurs zur Lösung der vielfältigen Zielkonflikte auf dem Weg zu einem nachhaltigen Pflanzenbausind wissenschaftliche Fakten über die Beziehungen zwischen den Zielen unabdingbar. Daher hat die Gesellschaft für Pflanzenbauwissen-schaften wissenschaftliche Befunde zu den Themenbereichen Biodiversität, Klimarelevanz und Klimaresilienz, Nährstoffmanagement,Pflanzenschutz, Bodenschutz und Produktion nachwachsender Rohstoffe zusammengestellt und den bestehenden Forschungsbedarfidentifiziert. Nach einem Executive Summary, das die Befunde schlaglichtartig darstellt, werden die Themenbereiche im Einzelnen ausgeführt. Ziel dieses Papiers ist nicht, Empfehlungen für die politische Entscheidungsfindung abzugeben, sondern die öffentliche Diskussiondurch Bereitstellung von Sachinformationen zu unterstützen.Scientific facts about the relationships between the goals are indispensable for the rational social discourse on solving the various conflict-ing goals on the way to sustainable crop production. Therefore, the German Society for Agronomy has compiled scientific findings on thetopics of biodiversity, climate relevance and climate resilience, nutrient management, crop protection, soil protection and production ofrenewable raw materials, and identified the existing need for research. After an executive summary that highlights the findings, the subjectareas are explained in detail. The purpose of this paper is not to make recommendations for policy-making, but to support the publicdebate by providing factual information