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Open Access 01-06-2021 | Septicemia | Topic Paper

Feasibility and relevance of urine culture during stone fragmentation in patients undergoing percutaneous nephrolithotomy and retrograde intrarenal surgery: a prospective study

Authors: E. De Lorenzis, L. Boeri, A. Gallioli, M. Fontana, S. P. Zanetti, F. Longo, R. Colombo, M. Arghittu, S. Piconi, G. Albo, A. Trinchieri, E. Montanari

Published in: World Journal of Urology | Issue 6/2021

Abstract

Purpose

We evaluated if, during lithotripsy, bacteria may be detected in the irrigation fluid of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). The concordance between urine culture from stone fragmentation (SFUC), bladder (BUC), renal pelvic (RPUC) and stone (SC) was analyzed. We also assessed the correlation between variables and cultures and their association with systemic inflammatory response syndrome (SIRS) and of a positive SC.

Methods

We included 107 patients who underwent PCNL (n = 53) and RIRS (n = 54) from January 2017 to May 2018. Samples for RPUC were obtained by renal catheterization. Stone fragments and irrigation fluid sample were sent for culture.

Results

SFUC was positive in 17 (15.9%), BUC in 22 (20.6%), RPUC in 26 (24.3%) and SC in 30 patients (28%). The concordance between SFUC and SC was the highest among all cultures: 94.1%. SFUC and SC grew identical microorganisms in 15/17 (88.2%) patients. Out of 17 (15.9%) patients with SIRS, 8 (7.5%) had sepsis. SFUC had the highest PPV and specificity to detect positive SC and SIRS. Previous urinary tract infection, a preoperative nephrostomy, stone diameter and composition, staghorn calculi, PCNL, positive BUC, RPUC and SFUC were predictors of infected stone. Variables that indicate complex stones, complex PCNL and an infection of the upper tract were associated with SIRS.

Conclusion

SFUC is technically feasible, easy to retrieve and to analyze. The spectrum of SFUC potential application in clinical practice is when is not possible to perform a SC, e.g. complete dusting or during micro-PCNL.

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Title: Feasibility and relevance of urine culture during stone fragmentation in patients undergoing percutaneous nephrolithotomy and retrograde intrarenal surgery: a prospective study
Authors: E. De Lorenzis
L. Boeri
A. Gallioli
M. Fontana
S. P. Zanetti
F. Longo
R. Colombo
M. Arghittu
S. Piconi
G. Albo
A. Trinchieri
E. Montanari
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Septicemia
Septicemia
Nephrostomy
Urinary Tract Infection
Nephrostomy
Urolithiasis
Published in: World Journal of Urology / Issue 6/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03387-6

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Feasibility and relevance of urine culture during stone fragmentation in patients undergoing percutaneous nephrolithotomy and retrograde intrarenal surgery: a prospective study

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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