Category: Clinical Stones: PCNL

MP26-8 - Early and rapid prediction for postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

To obtain more accurate and rapid predictors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) in complex kidney stone patients, and provide evidence for early prevention and treatment of postoperative infections.


Methods :

A total of 802 complex kidney stone patients undergone PCNL from September 2016 to September 2017 were recruited. Urine tests, urine cultures and stone cultures were performed, the perioperative data were prospectively recorded.


Results :

Sixty-two (7.7%) patients developed postoperative SIRS. A multivariate logistic regression analysis revealed that operating time ≥100 min, urine tests with both positive urine WBC and positive urine nitrite (WBC+NIT+), positive urine cultures (UC+) and positive stone cultures (SC+) were independent risk factors of SIRS. The incidence of postoperative SIRS was higher in the group of patients with WBC+NIT+ (28.7%) and the patients with both positive UC and positive SC (UC+SC+; 28.8%) than that in any other groups of patients (p<0.01). Preoperative WBC+NIT+ could predict UC+SC+ with accuracy of more than 90%. The main pathogens in kidney stones were Escherichia coli (43.8%), Proteus mirabilis (14.0%), Staphylococcus (7.4%), while main pathogens in urine were Escherichia coli (53.8%), Enterococcus (9.4%) and Proteus mirabilis (7.6%). The occurrence of Escherichia coli was more frequent in the group with SIRS than in the group without SIRS (p<0.05).


Conclusions :

WBC+NIT+ in preoperative urine tests could be considered as the early and rapid predictor for UC+SC+ and postoperative SIRS. SIRS following PCNL was more related to Escherichia coli infections in complex kidney stone patients. 

Wenqi Wu

urologist
First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China (People's Republic)

Dong Chen

First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China (People's Republic)

Wenqi Wu

urologist
First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China (People's Republic)