You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology I1 Apr 2018PD03-11 EXPANDED QUANTITATIVE CULTURE (EQC) DETECTS UNIQUE LIVE BACTERIA FROM KIDNEY STONES Petar Bajic, Michelle Van Kuiken, Bethany Burge, Alan Wolfe, Andrew Schwaderer, Bodo Knudsen, Larissa Bresler, Ahmer Farooq, Thomas Turk, and Kristin Baldea Petar BajicPetar Bajic More articles by this author , Michelle Van KuikenMichelle Van Kuiken More articles by this author , Bethany BurgeBethany Burge More articles by this author , Alan WolfeAlan Wolfe More articles by this author , Andrew SchwadererAndrew Schwaderer More articles by this author , Bodo KnudsenBodo Knudsen More articles by this author , Larissa BreslerLarissa Bresler More articles by this author , Ahmer FarooqAhmer Farooq More articles by this author , Thomas TurkThomas Turk More articles by this author , and Kristin BaldeaKristin Baldea More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.277AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While struvite stones are associated with colonization by urease-producing bacteria, the relationship between bacteria and stones remains otherwise poorly defined. Standard stone culture (SSC) identifies bacteria in 15-70% of stones, with E. coli and urease-producers predominating. SSC protocols are not conducive to growth by slow-growing, fastidious or anaerobic bacteria which comprise the vast majority of the urinary tract microbiota. Using EQC, we characterize the stone microbiome, specifically as it relates to stone composition. METHODS Stones were extracted from 70 patients; 22 undergoing percutaneous nephrolithotomy (PCNL) and 48 undergoing ureteroscopy (URS). All had pre-operative urinalysis or standard urine culture negative for infection. All patients received perioperative antibiotics. A portion of stone was sent for EQC and the remainder was sent for chemical analysis. Our EQC protocol utilizes 10-20x more specimen than SSC and a standardized homogenization technique. Colonies grown were identified using mass spectrometry. Relative abundance of bacterial species was compared to stone composition. RESULTS We identified growth from 22/70 (31.4%) stones with 90.9% of those being non-struvite. Growth was noted in 2/5 (40%) struvite, 7/18 (38.9%) calcium phosphate, 12/44 (27.3%) calcium oxalate and 1/6 (16.7%) uric acid dominated stones. The most common genera isolated were Staphylococcus (33.3%), Lactobacillus (16.7%) and Candida (13.3%). Lactobacillus, while not commonly associated with stones, was identified in 1 male and 4 female patients. Other unique species isolated include Aerococcus urinae and Streptococcus anginosus. CONCLUSIONS EQC detects diverse live bacteria from struvite and non-struvite stones following PCNL and URS, even following administration of perioperative antibiotics. Multiple traditionally non-uropathogenic bacteria were isolated, including Lactobacillus gasseri, Aerococcus urinae and Streptococcus anginosus. These three organisms have been associated with urge urinary incontinence in women in prior studies. While the clinical significance of these bacteria in stones remains unknown, further characterization of the stone microbiome may elucidate a pathophysiological relationship between bacteria and nephrolithiasis. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e75-e76 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Petar Bajic More articles by this author Michelle Van Kuiken More articles by this author Bethany Burge More articles by this author Alan Wolfe More articles by this author Andrew Schwaderer More articles by this author Bodo Knudsen More articles by this author Larissa Bresler More articles by this author Ahmer Farooq More articles by this author Thomas Turk More articles by this author Kristin Baldea More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...