Does preoperative urine culture still play a role in predicting post-PCNL SIRS? A retrospective cohort study

AbstractThere is controversy regarding the predicting value of preoperative urine culture for post-percutaneous nephrolithotripsy (PCNL) infection. The purpose of our study was to re-evaluate the importance of preoperative urine culture for developing post-PCNL systemic inflammatory response syndrome (SIRS) in China. A total of 303 patients undergone PCNL from March 2012 to January 2018 were recruited. Urine tests, urine cultures and the perioperative data were prospectively recorded and analyzed. 95 patients (31.4%) were identified with positive preoperative urine cultures. Female patients had significantly higher rate of urine cultures positivity than that in male patients (42.9% vs. 21.5%,p  <  0.01).Escherichia coli was the most common organism (56 cases, 58.9%) in patients with positive urine cultures and 35.7% ofE. coli-positive patients developed SIRS after PCNL. Even with intensive perioperative prophylaxis, patients with positive urine cultures had a higher rate of post-PCNL SIRS than those patients with negative urine cultures (p  =  0.043). On multivariable analysis, preoperative positive urine cultures (OR 1.943, 95% CI 1.11–3.39,p  =  0.019), preoperative neutrophils (OR 1.228, 95% CI 1.07–1.41,p  =  0.003), intraoperative pyonephrosis (OR 3.37, 95% CI 1.44–9.71,p  =  0.01) and postoperative hospitalization (OR 1.154, 95% CI 1.05–1.28,p  =  0.005) were independent risk factors for postoperative SIRS. These results demonstrated t...
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research