Analysis of consistency among the results of preoperative midstream urine culture, renal pelvis urine culture and renal stone culture in patients undergoing percutaneous nephrolithotomy and their relationship with postoperative infection
10.3760/cma.j.issn.1673-4904.2019.03.008
- VernacularTitle:经皮肾镜取石术患者术前中段尿培养、肾盂尿培养和肾结石培养结果一致性分析及其与术后感染的关系
- Author:
Shengjun XIA
1
;
Yong SHI
;
Jinxian PU
;
Xiaojun ZHAO
;
Jigen PING
Author Information
1. 江苏省盐城市中医院泌尿外科 224002
- Keywords:
Nephrostomy,percutaneous;
Sepsis;
Midstream urine culture;
Renal pelvic urine culture;
Renal stone culture
- From:
Chinese Journal of Postgraduates of Medicine
2019;42(3):225-229
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the consistency among the results of preoperative midstream urine culture (PMUC), renal pelvis urine culture (RPUC) and renal stone (RSC) culture in patients undergoing percutaneous nephrolithotomy (PNL) and their relationship with postoperative infection. Methods This was a multicenter prospective study. From September 2014 to November 2017, 115 patients undergoing standard channel PNL or microchannel PNL in the First Affiliated Hospital of Soochow University and Yancheng Hospital of Traditional Chinese Medicine were selected. The PMUC, RPUC and RSC were detected. Samples for RPUC and RSC were obtained during PNL. The clinical data, stone configuration, stone burden and results of cultures were recorded. Results In the 115 patients, PMUC positive was in 4 cases (3.5%), RPUC positive was in 17 cases (14.8%), and RSC positive was in 16 cases (13.9% ); both RPUC and RSC positive were in 7 cases (6.1% ), among whom consistent pathogenic bacterium was in 6 cases, and inconsistent pathogenic bacterium was in 1 case; all the 3 cultures were positive in 1 case, but the types of pathogenic bacterium of PMUC were totally different with RPUC and RSC. At least one positive of the 3 cultures was in 29 cases (25.2% ). The types of pathogenic bacterium of PMUC were multidrug susceptible Escherichia coli and Staphylococcus aureus , and the types of pathogenic bacterium of RPUC and RSC were multidrug resistant pathogens and/or fungus. The consistency of pathogenic bacterium between PMUC and RPUC, RSC was very low; while the consistency of pathogenic bacterium between RPUC and RSC was very high (6/7). Postoperative infection occurred in 8 of 115 patients (7.0% , 5 cases of infective fever and 3 cases of urinary sepsis). In the 8 patients, PMUC was negative, PRUC positive in 4 cases, RSC positive in 7 cases, and both PRUC and RSC positive were in 3 cases. Conclusions PMUC can not accurately reflect the true situation of upper urinary tract renal calculi and pyelo-urine pathogenic bacterium. In patients with PNL postoperative infectious complications, the result of PMUC is often negative, but the results of RPUC and RSC are mostly positive. RPUC and RSC are helpful to detecting pathogenic bacterium in time, guiding the application of sensitive antibiotics, preventing and treating PNL postoperative infection.
