A single-center study of the clinical characteristics of stone cultures and preoperative urine cultures of patients with kidney stones / 现代泌尿外科杂志

ABSTRACT

【Objective】 To analyze the clinical characteristics of stone culture and preoperative urine culture of patients with renal calculi in Songjiang area of Shanghai and the relationship with postoperative infection. 【Methods】 The clinical data of 213 patients with kidney stones treated at our hospital during Jan.2020 and Jun.2022 were retrospectively analyzed. All patients underwent preoperative clean midcourse urine culture, drug sensitivity test and stone culture. The gender difference between male and female patients and the difference in postoperative infection between stone/bacterial culture positive and negative patients were analyzed. 【Results】 Among the 213 patients, 47(22.1%) had positive urine culture, and the most common bacterium was Escherichia coli (20 strains, 42.6%). The proportion of Escherichia coli was significantly higher in female patients than in male patients [12 strains (48.0%) vs.8 strains (36.4%), P<0.05], while the proportion of Klebsiella pneumoniae was significantly higher in male patients than in female patients [5 strains (22.7%) vs. 3 strains (12.0%), P<0.05]. Drug sensitivity results showed the main Gram-negative bacteria were highly resistant to ampicillin/sulbactam, cefazolin and cefuroxime, but sensitive to imipenem, kanamycin and piperacillin/tazobactam. The main Gram-positive bacteria were highly resistant to clindamycin, erythromycin and levofloxacin, but sensitive to vancomycin, teicoplanin and linezolid. Stone culture was positive in 31 cases (14.6%), and the most common bacterium was Proteus mirabilis (9 strains, 29.0%). However, there was no significant difference in the main bacterial spectrum between male and female patients. The positive rate of urine culture/stone culture in patients with postoperative fever/urosepsis was significantly higher than that in patients with negative urine culture/stone culture (P<0.05). 【Conclusion】 Escherichia coli is the main urinary spectrum of patients with kidney stones in Songjiang area, which is greatly different from the stone culture results. In clinical practice, etiological detection and antibiotics are necessary to reduce the occurrence of postoperative infection.