The Role of Bacteria in Urology 2016
DOI: 10.1007/978-3-319-17732-8_5
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Struvite Stone Formation by Ureolytic Biofilm Infections

Abstract: This chapter describes how urinary tract infections can lead to stone formation. The most frequent type of infection stone is struvite (MgNH 4 PO 4 • 6H 2 O), although it is common that struvite stones and infections are associated with other stone types, often forming large staghorn calculi. A complete understanding of struvite stone formation requires knowledge of the pathogen biology, including metabolic activity and motility, as well as a basic understanding of how minerals form.The pathogens responsible f… Show more

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Cited by 8 publications
(4 citation statements)
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“…Part of this increase is related to the relationship between urolithiasis and major public health problems such as metabolic syndrome [5,6]. Urinary tract infection (UTI) leading to the formation of kidney stones can also be considered a relevant factor [7,8]. In view of the increase in infection-related stones over the past two decades, UTI must always be considered a significant possible cause of urolithogenesis [9][10][11][12][13].…”
Section: Introductionmentioning
confidence: 99%
“…Part of this increase is related to the relationship between urolithiasis and major public health problems such as metabolic syndrome [5,6]. Urinary tract infection (UTI) leading to the formation of kidney stones can also be considered a relevant factor [7,8]. In view of the increase in infection-related stones over the past two decades, UTI must always be considered a significant possible cause of urolithogenesis [9][10][11][12][13].…”
Section: Introductionmentioning
confidence: 99%
“…While biomineralization in urinals is due to a combination of various mechanisms, a key contributor to its formation is the hydrolysis of urea, or ureolysis, catalyzed by the microbial enzyme, urease. The prevalence, mineral composition, and formation of ureolytic crystallization is a function of urine chemistry such as the pH and ionic strength, modulators and inhibitors of crystallization, and the bacterial community [5][6][7][8][9][10]. Though ammonification of proteins and dissimilatory nitrate reduction to ammonia contributes to pH increases, ureolysis has been considered the most efficient pathway to raise pH into the range required in biomineral formation [11][12][13][14][15].…”
Section: Introductionmentioning
confidence: 99%
“…Ureolytic bacteria responsible for the biomineralization use the nickel-dependent metalloenzyme, urease, to catalyze the hydrolysis of urea into ammonia and bicarbonate which in turn raises the pH and creates conditions favorable of precipitation [4]. In a past catheter study, researchers have demonstrated that rates of calcium and magnesium encrustation caused by various ureolytic bacteria isolates are correlated with an increase in ureolytic activity [9] An elevated pH promotes calcium phosphate and oxalate stone formation due to a shift in phosphate speciation from HPO 4 2− to PO 4 3− and the decomposition of ascorbic acid into oxalate-both cases represent an increase in ion concentrations that lead to elevated encrustation rates found in catheters [10]. Ureolysis also results in carbonate and bicarbonate ion formation which can further contribute to biomineralization as the urine becomes supersaturated [11].…”
Section: Introductionmentioning
confidence: 99%