<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Objective</bold>: To evaluate the bacteriological features in non-struvite nephrolithiasis and in its associated urinary tract infection, and to establish the relationship between the two pathologies.<bold>Methods</bold>: The non-struvite calculi from 132 patients were aseptically extracted by percutaneous nephrolithotomy (PNL). The midstream urine and calculi were bacteriologically and biochemically processed.<bold>Results</bold>: Most calculi (78%) were located to renal pelvis, associated with hydronephrosis, the biochemical composition confirming the lack of struvite and revealing the predominance of calcium oxalate. The females presented significantly more colonized calculi (50%) than males (21.9%), with higher bacteriological diversity. There is a significant relation between the presence of colonized calculi and urinary tract infections, 24.2% of calculi and 25.8% of the urine samples presenting positive cultures. In 70.4% of cases, we found the same antibiotic resistance pattern between the pathogens isolated from calculi and urine, thus considering them identical strains. The Enterobacteriaceae represented the most predominant bacteria both from calculi (62.5%) and urine (63.6%), approximatively 30% being resistant to cephalosporins and over 50% resistant to fluoroquinolones, ampicillin and tetracycline. There were 3.8% of cases in which the calculi were colonized but the urine was sterile, the bacteria being sensitive to cephalosporins that are used as prophylaxis.<bold>Conclusions</bold>: In all the cases, the same bacterial species was found both in calculi and urine, and 70.4% of them were phenotypically identical. The resistance to the second generation cephalosporins is lower than in the case of other antibiotics, which makes them the most suitable for prophylaxis in PNL.</abstract>

Objective: To evaluate the bacteriological features in non-struvite nephrolithiasis and in its associated urinary tract infection, and to establish the relationship between the two pathologies.Methods: The non-struvite calculi from 132 patients were aseptically extracted by percutaneous nephrolithotomy (PNL). The midstream urine and calculi were bacteriologically and biochemically processed.Results: Most calculi (78%) were located to renal pelvis, associated with hydronephrosis, the biochemical composition confirming the lack of struvite and revealing the predominance of calcium oxalate. The females presented significantly more colonized calculi (50%) than males (21.9%), with higher bacteriological diversity. There is a significant relation between the presence of colonized calculi and urinary tract infections, 24.2% of calculi and 25.8% of the urine samples presenting positive cultures. In 70.4% of cases, we found the same antibiotic resistance pattern between the pathogens isolated from calculi and urine, thus considering them identical strains. The Enterobacteriaceae represented the most predominant bacteria both from calculi (62.5%) and urine (63.6%), approximatively 30% being resistant to cephalosporins and over 50% resistant to fluoroquinolones, ampicillin and tetracycline. There were 3.8% of cases in which the calculi were colonized but the urine was sterile, the bacteria being sensitive to cephalosporins that are used as prophylaxis.Conclusions: In all the cases, the same bacterial species was found both in calculi and urine, and 70.4% of them were phenotypically identical. The resistance to the second generation cephalosporins is lower than in the case of other antibiotics, which makes them the most suitable for prophylaxis in PNL.

Bacteriological evaluation of the non-struvite nephrolithiasis and its association with urinary tract infections

1. Department of Urology, University of Medicine and Pharmacy Tirgu Mures, Romania

2. Department of Microbiology, University of Medicine and Pharmacy Tirgu-Mures, Romania

3. Department of Microbiology, Clinical County Hospital Mures, Romania

4. Department of Biochemistry, University of Medicine and Pharmacy Tirgu Mures, Romania

Revista Romana de Medicina de Laborator

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Evaluarea bacteriologică a nefrolitiazei non-struvitice și asocierea ei cu infecții ale tractului urinar

Objective: To evaluate the bacteriological features in non-struvite nephrolithiasis and in its associated urinary tract infection, and to establish the...

Bacteriological evaluation of the non-struvite nephrolithiasis and its association with urinary tract infections

Published Online: Dec 30, 2015

Page range: 457 - 468

Received: Apr 01, 2015

Accepted: Nov 18, 2015

DOI: https://doi.org/10.1515/rrlm-2015-0045

Keywords
nephrolithiasis, non-struvite calculi, percutaneous nephrolithotomy, phenotypic similarity, chemical composition

© 2015 Adrian Maier et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Bacteriological evaluation of the non-struvite nephrolithiasis and its association with urinary tract infections

Published Online: Dec 30, 2015

Page range: 457 - 468

Received: Apr 01, 2015

Accepted: Nov 18, 2015

DOI: https://doi.org/10.1515/rrlm-2015-0045

Keywordsnephrolithiasis, non-struvite calculi, percutaneous nephrolithotomy, phenotypic similarity, chemical composition

© 2015 Adrian Maier et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
nephrolithiasis, non-struvite calculi, percutaneous nephrolithotomy, phenotypic similarity, chemical composition