Category: Clinical Stones: Ureteroscopy

MP29-15 - The clinical implication of renal stone culture during the retrograde intrarenal surgery

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Some kinds of urinary stones are known to be associated with urinary tract infection. However, microbiologic characteristics of urinary stone have been rarely studied. The aim of this study is to evaluate the clinical implication of renal stone culture during the retrograde intrarenal surgery (RIRS).


Methods :

All consecutive patients who underwent RIRS at our hospital were included in this prospective observational study from April 2016 to September 2017. Stone fragments extracted during the procedure were sent for culture. Clinical variables, stone configuration and microbiology reports of cultures were recorded. 


Results :

A total of 322 patients underwent RIRS. Mean age and body mass index were 66.0 ± 13.8 years and 25.2 ± 3.6 kg/m2. Male patients were dominant as 62.7% (208/332). Mean stone diameter was 10.3 ± 6.0 mm. Stone cultures results were positive at 84.6% (281/332) patients. Stone composition such as struvite and ammonium urate was not related with the stone culture results. In the microbiology reports, bacillus and coagulase negative staphylococcus were major pathogens (32.2%, and 30.7%). Each of other pathogen captured fewer than 6%. Most of stone culture reports showed multidrug-resistance. Penicillin had 62.1% resistance. Ciprofloxacin (25.5%) and Trimethoprim/sulfamethoxazole (15.4%) followed in order. In contrast, vancomycin showed fair susceptibility (98.8%). Stone culture results was not associated with preoperative urine culture (6% positivity) and postoperative infectious events (2.1% cases). 


Conclusions :

Stone culture results reveals that considerable number of pathogens may contribute to the generation of urinary stone. And stone culture reports can help choose appropriate antibiotic treatment for patients who suffer from postoperative infectious complications after RIRS. 

Juhun Park

Professor
SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Assistant professor
SMG-SNU Boramae Medical Center
(SMG-SNU: Seoul Metropolitan Government-Seoul National University)
Department of Urology
20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea

Juhyun Park

SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Sangjun Yoo

SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Min Chul Cho

SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Hwancheol Son

SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Hyeon Jeong

SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Sung Yong Cho

Department of Urology, Seoul National University, Seoul, South Korea
SMG-SNU Boramae Medical Center
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Jae Hyun Jung

Fellow
Seoul National University Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Jae Hyun Jung, M.D.
Clinical Fellow Department of Urology
Seoul National University Hospital
101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-1968
Cell : +82-10-9159-5735
Fax: +82-2-742-4665
E-mail: genejh@hanmail.net

Gwan Jang

3rd year resident
Seoul National University Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea

SNUH department of urolog, 3rd degree resident. training 3 of 4.