Jessica E Paonessa1, Ehud Gnessin2, Naeem Bhojani3, James C Williams4, James E Lingeman5. 1. Syracuse University School of Medicine, Syracuse, New York. 2. Hebrew University of Jerusalem, Hadassa Medical School, Jerusalem, Israel. 3. University of Montreal, Montreal, Quebec, Canada. 4. Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana. 5. Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: jlingeman@iuhealth.org.
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.
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.
Authors: Jennifer N Walker; Ana L Flores-Mireles; Chloe L Pinkner; Henry L Schreiber; Matthew S Joens; Alyssa M Park; Aaron M Potretzke; Tyler M Bauman; Jerome S Pinkner; James A J Fitzpatrick; Alana Desai; Michael G Caparon; Scott J Hultgren Journal: Proc Natl Acad Sci U S A Date: 2017-09-25 Impact factor: 11.205
Authors: Christian D Fankhauser; Thomas Hermanns; Laura Lieger; Olivia Diethelm; Martin Umbehr; Thomas Luginbühl; Tullio Sulser; Michael Müntener; Cédric Poyet Journal: Clin Kidney J Date: 2018-01-25