A Clinical Study of Upper Urinary Tract Calculi Treated with Extracorporeal Shock Wave Lithotripsy: Association with Bacteriuria before Treatment

Shigeta, Masanobu; Hayashi, Mutsuo; Igawa, Mikio

doi:10.1159/000282726

Cited by 18 publications

(6 citation statements)

References 8 publications

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“…Szigeti et al found infected stones in 10% of their 57 patients with renal stones and they noted that bacteriuria was more prevalent in stones greater than 30mm in diameter. 20 Although in our series stone bulk did not directly correlate with uro sepsis, more of the larger stones(greater than 20mm ) were infected. We also noted that the turbidity of urine at pelvicaliceal system puncture did not correlate with SIRS and positive Pelvic urine because only 50% of the patients with cloudy urine had infected stones or positive pelvic urine culture.…”

Section: Discussion:-contrasting

confidence: 66%

A Study of Correlation Between Different Sites of Urine Sampling, Including Stones as Predictors of Urosepsis Following Percutaneous Nephrolithotomy.

Venugopal¹,

ShanmughaDasK²,

Varghese³

et al. 2017

IJAR

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Aim:To determine the correlation between urine sampling from different sites, including stones, and also to ascertain which is more predictive of urosepsis. Material and Methods:All patients undergoing PCNL in Government Medical College Hospital, Calicut during the period of one year (from March 2016 to February 2017) who fulfilled our selection criteria were recruited. The samples collected were 1) midstream urine and bladder urine at cystoscopy, 2) renal pelvic urine collected at the time of ureteric catheter insertion 3) renal pelvic urine collected at percutaneous puncture of the pelvicaliceal system and 4) stones which were extracted. The samples were sent immediately for C&S. Patients were monitored for systemic inflammatory response sysndrome (SIRS). Results: Total of 135 cases were suitable for analysis. Midstream urine C&S was positive in 9.63% of cases. Stone C&S was positive in 30.37% and pelvic C&S was positive in 20.74%. Pelvic urine C&S was a better predictor of infected stones than bladder urine C&S. Of the 135 patients 31.9% had SIRS and 4 patients experienced septic shock. Patients with infected stones or pelvic urine were found to be at a relative risk for urosepsis that was at least 10 times greater (p<0.0001). Bladder urine was not a good predictor of SIRS. Stone C&S had a positive predictive value of 0.7, which was the highest. Preoperative dilatation of pelvicalyceal system correlated with infected pelvic urine. None of the patients with urosepsis had positive blood C&S. Conclusions: Positive stone C&S and pelvic urine C&S are better predictors of urosepsis than bladder urine in our study. So, routine collection of pelvic urine and stone for culture and sensitivity is recommended.

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Section: Discussion:-contrasting

confidence: 66%

A Study of Correlation Between Different Sites of Urine Sampling, Including Stones as Predictors of Urosepsis Following Percutaneous Nephrolithotomy.

Venugopal¹,

ShanmughaDasK²,

Varghese³

et al. 2017

IJAR

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“…They diagnosed 10% of the patients with an infected stone and found out that in cases of a stone size bigger than 30 mm, bacteruria is more common [20]. In our study stone burden is related with SIRS or with urosepsis in the ciprofloxacin group but there is no such relationship with the ceftriaxone group.…”

Section: Commentmentioning

confidence: 41%

Comparison of Infection and Urosepsis Rates of Ciprofloxacin and Ceftriaxone Prophylaxis before Percutaneous Nephrolithotomy: A Prospective and Randomised Study

Demirtaş

Yıldırım

Sofikerim

et al. 2012

The Scientific World Journal

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This study aimed at determining the choice and administration duration of ideal antibiotic prophylaxis before percutaneous nephrolithotomy (PNL) operation, a treatment modality for nephrolithiasis. The study included 90 patients who had no internal problem, yet had a negative urine culture and underwent a PNL operation. We compared infection rates between ciprofloxacin and ceftriaxone groups and their subgroups. The results showed no statistical difference between ciprofloxacin and ceftriaxone groups in terms of systemic inflammatory response syndrome (SIRS) (CIPP = 0.306, CTX P = 0.334. As a result of this study no statistical difference was observed between ciprofloxacin and ceftriaxone in terms of SIRS. It seems, however, reasonable to choose ceftriaxone, considering antibiotic sensitivity of microorganisms and detection of three cases accepted as urosepsis in the ciprofloxacin group. As there is no difference between short, and long-term prophylactic use of these antibiotics, preference of short-term prophylaxis for patients with no risk of infection will be important to avoid inappropriate antibiotic usage.

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“…Conversely, stone and pelvic urine C&S were better predictors of urosepsis after surgery and large stones appeared more likely to be infected. Shigeta et al [12] found infected stones in 10% of their 57 patients with renal stones, and found that bacteriuria was more prevalent in stones of > 30 mm in diameter. However, Gault et al [13] attributed the lower risk of infected stones in their series (5.6%) to a longer period of preoperative antibiotics, using fluoroquinolones.…”

Section: Discussionmentioning

confidence: 99%

One week of ciprofloxacin before percutaneous nephrolithotomy significantly reduces upper tract infection and urosepsis: a prospective controlled study

et al. 2006

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Urosepsis after percutaneous nephrolithotomy (PCNL) is a severe complication, and its avoidance can sometimes be difficult despite antibiotic prophylaxis. Authors from the UK with a considerable experience in this procedure describe a prospective controlled study using ciprofloxacin for 1 week before PCNL, and found that it significantly reduces the risk of urosepsis. OBJECTIVE To evaluate whether 1 week of ciprofloxacin before percutaneous nephrolithotomy (PCNL) in patients with stones of ≥ 20 mm or pelvicalyceal dilatation, reduces urosepsis, as we previously reported that such patients have four times the risk of urosepsis after PCNL. PATIENTS AND METHODS Patients undergoing PCNL, and who fulfilled strict selection criteria, were recruited prospectively into a study which was conducted in two phases. The study methods were similar to those previously described; patients with dilated pelvicalyceal systems and/or stones of ≥ 20 mm from phase 1 (previously published) acted as controls. In the subsequent phase, the same selection criteria applied and only those with stones of ≥ 20 mm and/or dilated pelvicalyceal systems were given ciprofloxacin 250 mg twice daily for 1 week before PCNL and comprised the treatment arm. Midstream urine samples, renal pelvic urine and fragmented stones were collected to assess culture and sensitivity. Systemic inflammatory response syndrome (SIRS) was used to define urosepsis after PCNL. The urologists monitoring the patients after PCNL and conducting the analysis were all unaware of the characteristics of the stones or intravenous urography findings before PCNL. In all, 115 patients (54 in phase 1 and 61 in phase 2) were recruited, of whom 46 in phase 1 and 52 in phase 2 had stones of ≥ 20 mm and/or a dilated pelvicalyceal system, and became the control and treatment arms, respectively. RESULTS The patient demographics were similar in both arms. There was three times less risk of upper tract infection (relative risk 3.4, 95% confidence interval 1.0–11.8, P = 0.04) and SIRS (2.9, 1.3–6.3, P = 0.004) in the patients receiving ciprofloxacin (treatment arm). CONCLUSIONS The administration of oral ciprofloxacin for 1 week before PCNL in patients with stones of ≥ 20 mm or dilated pelvicalyceal systems significantly reduced the risk of urosepsis.

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A Clinical Study of Upper Urinary Tract Calculi Treated with Extracorporeal Shock Wave Lithotripsy: Association with Bacteriuria before Treatment

Cited by 18 publications

References 8 publications

A Study of Correlation Between Different Sites of Urine Sampling, Including Stones as Predictors of Urosepsis Following Percutaneous Nephrolithotomy.

A Study of Correlation Between Different Sites of Urine Sampling, Including Stones as Predictors of Urosepsis Following Percutaneous Nephrolithotomy.

Comparison of Infection and Urosepsis Rates of Ciprofloxacin and Ceftriaxone Prophylaxis before Percutaneous Nephrolithotomy: A Prospective and Randomised Study

One week of ciprofloxacin before percutaneous nephrolithotomy significantly reduces upper tract infection and urosepsis: a prospective controlled study

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