The Impact of Nephrostomy on Urinary Tract Infections – A Literature Review

Background: Percutaneous nephrostomy (PCN) is a minimally invasive procedure used to decompress the renal collecting system in cases of urinary tract obstruction. Although effective, it introduces an external drainage system that increases the risk of urinary tract infections (UTIs), especially catheter-associated UTIs (CAUTIs), due to direct microbial access. Aim: This study aims to analyze the incidence, mechanisms, risk factors, microbial profiles, clinical management, and prevention strategies of UTIs associated with PCN. Material and Methods: A systematic review was performed using PubMed, Scopus, Web of Science, and Google Scholar, covering publications from 2000 to 2025. Included studies involved adult patients undergoing PCN. The synthesis was narrative and focused on epidemiology, pathophysiology, and prevention. Results: UTIs occur in up to 35% of PCN patients. Key risk factors include prolonged catheterization, inadequate aseptic technique, and multidrug-resistant organisms. Biofilm formation on catheter surfaces plays a central role in pathogenesis. CAUTI incidence ranges from 8% to 40%, influenced by catheter dwell time, patient comorbidities, and catheter care. Predominant pathogens include Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, with an increasing presence of resistant strains. Preventive measures include strict asepsis, regular catheter exchange, rational antibiotic use, and patient education. Conclusions: PCN increases the risk of UTIs due to its invasive nature and biofilm-related colonization. A multifaceted prevention approach combining technical precision, infection monitoring, and improved catheter design is essential to reduce CAUTI rates in PCN patients.