Original Article Predictors of Post per cutaneous nephrolithotomy sepsis – A prospective comparative study of bacteriology of Mid stream urine culture, Renal pelvis urine culture and stone culture with a view to prevent and treat sepsis.
Predictors of Post per cutaneous nephrolithotomy sepsis – A prospective comparative study of bacteriology of Mid stream urine culture, Renal pelvis urine culture and stone culture with a view to prevent and treat sepsis.
DOI:
https://doi.org/10.15713/ins.bhj.100Keywords:
Urine culture,renal pelvis urine culture ,stone culture,urosepsis.Abstract
Abstract:
Aim: To find the correlation between preoperative midstream urine culture, intraoperative renal pelvis urine culture and renal stone culture with the postoperative infections and clinical episodes suggestive of urosepsis, in patients treated with percutaneous renal surgeries for renal stone disease.
Background:
1) To study correlation between preoperative midstream urine culture, intraoperative renal pelvis urine culture and intraoperative renal stone culture.
2) To understand which of these culture specimens i.e. preoperative midstream urine culture, intraoperative renal pelvis urine culture or intraoperative renal stone culture, will predict urosepsis in patients undergoing percutaneous renal surgery for renal
Conclusion
Postoperative sepsis is one of the most feared events associated with PCNL.
We found that preoperative midstream urine culture may not accurately reflect the bacteriological status of the renal stone and pelvic urine.
Both positive renal pelvis urine culture and positive preoperative midstream urine culture had statistically significant association with stone culture positivity. Positive renal pelvis urine culture had stronger association with stone culture positivity compared to preoperative midstream urine culture.
Preoperative midstream urine culture is not a good predictor of SIRS/sepsis following PCNL.Sepsis related complications can arise despite sterile urine or adequately treated preoperative urine culture. Intraoperative renal pelvis urine culture and renal stone cultures are better predictors of postoperative sepsis/relevant clinical events.
These culture results can help to identify causative organism of urosepsis and helps to direct antimicrobial treatment, if sepsis develops
Clinical Significance - Sepsis related complications can arise despite sterile urine or adequately treated preoperative urine culture. Intraoperative renal pelvis urine culture and renal stone cultures are better predictors of postoperative sepsis/relevant clinical events
References
Doǧan HS, Şahin A, Çetinkaya Y, Akdoģan B, Özden E,
Kendi S. Antibiotic prophylaxis in percutaneous nephrolithotomy:
Prospective study in 81 patients. J Endourol 2002;16:649-53.
Evans L, Rohdes A, Alhazzani W, Antolenni M, Coppersmith CM,
French C, et al. Surviving sepsis campaign: International guidelines
for management of sepsis and septic shock. Crit Care Med
;47:1181-247.
Mariappan P, Smith G, Bariol SV, Moussa SA, Tolley DA. Stone and
pelvic urine culture and sensitivity are better than bladder urine as
predictors of urosepsis following percutaneous nephrolithotomy:
A prospective clinical study. J Urol 2005;173:1610-4.
Devraj R, Tanneru K, Reddy B, Amancherla H, Chilumala R.
Renal stone culture and sensitivity is a better predictor of potential
urosepsis than pelvic or midstream urine culture and sensitivity.
J NTR Univ Health Sci 2016;5:261-4.
McAleer IM, Kaplan GW, Bradley JS, Carroll SF, Griffith DP.
Endotoxin content in renal calculi. J Urol 2003;169:1813-4.
Urology A. Clinical implication of routine stone culture in
percutaneous nephrolithotomy--a prospective study. Urology
;67:26-9.
Korets R, Graversen JA, Kates M, Mues AC, Gupta M. Postpercutaneous
nephrolithotomy systemic inflammatory response:
A prospective analysis of preoperative urine. Renal Pelvic Urine
Stone Cult 2011;186:1899-903.
Lojanapiwat B, Rod-Ong P, Kitirattrakarn P, Chongruksut W. Guy’s
stone score (GSS) based on intravenous pyelogram (IVP) findings
predicting upper pole access percutaneous nephrolithotomy
(PCNL) outcomes. Adv Urol 2016;2016:5157930.
Walton-Diaz A, Vinay JI, Barahona J, Daels P, González M,
Hidalgo JP, et al. Concordance of renal stone culture: PMUC,
RPUC, RSC and post-PCNL sepsis-a non-randomized prospective
observation cohort study. Int Urol Nephrol 2017;49:31-5.
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