MP89-08 STONE CULTURE IS NOT BETTER THAN BLADDER URINE CULTURE AS SIRS PREDICTOR AFTER PERCUTANEOUS NEPHROLITHOTOMY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy VI1 Apr 2018MP89-08 STONE CULTURE IS NOT BETTER THAN BLADDER URINE CULTURE AS SIRS PREDICTOR AFTER PERCUTANEOUS NEPHROLITHOTOMY Alfio Corsaro, Mehmet Özsoy, Julian Veser, and Christian Seitz Alfio CorsaroAlfio Corsaro More articles by this author , Mehmet ÖzsoyMehmet Özsoy More articles by this author , Julian VeserJulian Veser More articles by this author , and Christian SeitzChristian Seitz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2948AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite antbiotic coverage, systemic inflammatory response syndrome (SIRS) following percutaneous nephrolithotomy (PNL) can be a life-threatening event, thus trying to minimize the incidence of infectious complications after PNL could be a valuable goal for urologist. The aim of this study is to assess the efficacy of kidney stone culture as a predictor for post-operative SIRS after PNL when compared to bladder urine culture. METHODS We examined retrospectively the clinical records of patients who underwent PCN in the last 3 years and had bladder urine and stone culture performed. We then looked for SIRS signs defined as the development of at least 2 of the following 4 criteria: fever less than 36°C or greater than 38°C, heart rate greater than 100 beats per minute, respiratory rate greater than 20 breaths per minute and white cell count greater than 12x10ˆ9/l or less than 4x10ˆ9/l. We performed statistical analysis of the data obtained using chisquare test to determine associations among the various groups and subgroups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and association risk were calculated both for preoperative bladder urine culture and stone culture. RESULTS A total of 102 patients were included in our analysis based on our selection criteria. Preoperative bladder urine culture was positive in 42% of patients while stone culture was positive in 33% of patients with no statistical differences among the two groups (p >.05). Both Bladder urine and stone cultures we positive in 20% of patients and grew identical microorganisms in 68,4% of the patients. SIRS was observed in 7% of patients of whom 85,7% had positive bladder urine culture, 57% had positive stone culture and 42,8% had both positive cultures with a 100% pathogen concordance. Bladder urine culture had a sensitivity of 85,71% , a specificity of 61,63% with a PPV of 15,38 a NPV of 98,15% and a RR of 8,3077 (95% CI 1,0414 to 66,2722) while stone culture had a sensitivity of 57,14% , a specificity of 68,6% with a PPV of 12,9 a NPV of 95,16% and a RR of 2,6667 (95% CI 0,6359 to 11,1828). CONCLUSIONS The results of this study suggest that stone culture is not a better predictor than bladder urine culture as predictor of SIRS after PNL, therefore we recommend a routine collection of bladder urine culture, while we cannot recommend to perform stone culture on a regular basis. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1208-e1209 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Alfio Corsaro More articles by this author Mehmet Özsoy More articles by this author Julian Veser More articles by this author Christian Seitz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...