title: For reliable urine cultures in the detection of complicated urinary tract infection, do we use urine specimens obtained with urethral catheter or a nephrostomy tube?
abstract: OBJECTIVE
  The aim of this study was to compare the results of urine cultures obtained either from urethral, and percutaneous nephrostomy (PCN) catheters.
  
  
  METHODS
  This study included 328 consecutive patients that underwent PCN at our institution with complicated urinary tract infections (UTIs) between July 2010 and April 2015. Results of urine cultures obtained from the urethral and nephrostomy catheters were compared.
  
  
  RESULTS
  This study included 152 male and 176 female patients. Mean age of the patients was 46.2±24.3 years. The main indications were obstructive uropathy due to urolithiasis complicated with pyonephrosis 145 (44%), malignant disease (n=87; 26%), pregnancy (n=26; 8%), and anatomical abnormality (n=23; 7%). One hundred and twenty three patients had diabetes mellitus. The most common causative organisms wereEscherichia coli,Klebsiella pneumoniae, andPseudomonas aeruginosa. Blood cultures showed the same results for the PCN and bladder urine cultures. The bladder urine culture was positive in 304 patients, while the PCN urine culture in 314 patients.
  
  
  CONCLUSIONS
  PCN is an important treatment for the management of pyonephrosis. Cultures from the PCN yield valuable information that is not available from urethral urine cultures, and is a guiding tool for antibiotic therapy selection.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
authors.forename: Gülay
authors.initials: G
authors.lastname: Dede
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Özcan
authors.initials: Ö
authors.lastname: Deveci
authors.affiliation: Department of Urology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Dede
authors.affiliation: Department of Urology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Mazhar
authors.initials: M
authors.lastname: Utanğac
authors.affiliation: Department of Urology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Mansur
authors.initials: M
authors.lastname: Dağgulli
authors.affiliation: Department of Urology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Necmettin
authors.initials: N
authors.lastname: Penbegül
authors.affiliation: Department of Urology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Namık Kemal
authors.initials: NK
authors.lastname: Hatipoğlu
keywords: Complicated urinary tract infection; percutaneous nephrostomy culture; urethral culture