Infectious complications associated with percutaneous nephrostomy catheters: do we know enough?

The percutaneous nephrostomy catheter (PCNC) has evolved since its inception. Over more than half a century, it has gone from a temporary maneuver to a permanent fixture in a large proportion of patients who have incurable illnesses with obstructed renal drainage systems. Unfortunately, the research looking specifically at infectious complications associated with PCNCs suffers from oversimplification as studies predominantly assess sepsis alone. There are no standardized definitions or criteria to define the various infectious complications described in this paper. Although the PCNC has a relative paucity of infectious complications, which represents an excellent marker for patient care, the low rate of infection dictates a large sample size for sufficiently-powered research studies to be able to find a significant impact of interventional measures. In this review article, we discuss various aspects of pathogenesis and treatment of the different subtypes of PCNC-associated infections.