Comparison pre-operative urine culture, pelvic urine culture and stone culture study in percutaneous nephrolithotomy patients

Abstract

Background: Urinary stones are a common disease in urological surgery patients. According to statistics in Nong Bua Lam Phu Hospital for 3 years from January 2017 to January 2020, It was found that there were 229, 253 and 284 inpatient treatments per year for kidney stones and ureter stones, respectively. 75% of cases are infected due to stones, and the incidence of sepsis is up to 5%. It is imperative to know the causative organism which will direct proper antibiotics usage.

Objective: The study was aimed to compare the bacterial culture data from preoperative urine, urine from renal pelvis and stone, obtaining from percutaneous nephrolithotomy procedure(PCNL). The results will be used as a guideline for optimal antibiotics choice, which will reduce the incidence of septicemia.

Method: This is a diagnostic research, cross-sectional study. The data of 242 patients with kidney stones, underwent percutaneous nephrolithotomy(PCNL) was retrospectively collected from January 2017 to January 2020. Pre-operative midstream urine culture, urine from renal pelvis and stone were sent for culture within 2 hours after procedure.

Results: 79% of the patients had a positive stones culture, 33% had a positive preoperative urine culture, 24% had a positive urine culture from renal pelvis. The bacterial strain from all three sources of a patient was identical. E.coli was the most common organism, followed by Streptococci spp. The top five antibiotic susceptible organisms are Tazocin, Amikacin, Sulperazone, Ceftriaxone, and Meropenem.

Conclusion: The most common organism is E.coli. It is found most commonly in stone culture.
Ceftriaxone can also be used as a prophylaxis antibiotic.