Preoperative Bladder Urine Culture as a Predictor of Intraoperative Stone Culture Results: Clinical Implications and Relationship to Stone Composition

Abstract

Purpose We examine the relationship between urine and stone cultures in a large cohort of patients undergoing percutaneous stone removal and compare the findings in infectious vs metabolic calculi. Materials and Methods A total of 776 patients treated with percutaneous nephrolithotomy who had preoperative urine cultures and intraoperative stone cultures were included in the study. Statistical analysis used chi-square or logistic fit analysis as appropriate. Results Preoperative urine culture was positive in 352 patients (45.4%) and stone cultures were positive in 300 patients (38.7%). There were 75 patients (9.7%) with negative preoperative cultures who had positive stone cultures, and in patients with both cultures positive the organisms differed in 103 (13.3%). Gram-positive organisms predominated in preoperative urine and stone cultures. Conclusions Preoperative urine cultures in patients undergoing percutaneous nephrolithotomy are unreliable as there is a discordance with intraoperative stone cultures in almost a quarter of cases. There has been a notable shift toward gram-positive organisms in this cohort of patients.

Early and rapid prediction of postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones

“…Previous studies have shown that the outcome of UCs and SCs are not always identical . In an American single‐centre study, Staphylococcus was identified as the most common bacteria in both urine and stones, whilst the bacterial spectrum of urine was not the same as that of the stones . Correspondingly, in the present study, we also found that the bacterial spectrum of urine was different from that of stones, although E. coli was the most common bacteria in both urine and stones in our patients with complex kidney stones.…”

Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract

“…It is, however, an emerging cause of complicated UTIs, including infected kidney stones (11,(47)(48)(49) and CAUTIs (4,8,9,12,21). Here we resolve this paradox by demonstrating that MRSA exploits the presence of Fg that is released as part of an inflammatory response induced by the presence of a foreign body.…”

Fever and systemic inflammatory response syndrome after retrograde intrarenal surgery: Risk factors and predictive model

“…We retrospectively collected the data of 484 patients who underwent RIRS at our center between 2010 and 2017. Patients with incomplete data (62, mainly due to unknown urine or stone culture results), severe comorbidities (43, mainly severe cardiovascular or respiratory diseases), the presence of contralateral renal or ureteral stone (18) and renal failure (24) were excluded. Ultimately, 337 patients were enrolled for analysis.…”