ページの先頭です
HOME > Past Issue List > Issue List > Abstract
言語を選択(Language)
日本語(Japanese)English

Abstract

Vol.68 No.5 September 2020

Impact of postoperative urine culture after ureterorenoscopic lithotripsy

Hideo Otsuki, Shunsuke Hori, Tomonori Kojima, Yukihide Matsui, Hiroshi Aoki, Tomoya Yamasaki and Kei Fujio

Department of Urology, Abiko Toho Hospital, 1851-1 Abiko, Abiko city, Chiba, Japan

Abstract

Purpose
The purpose of this study was to identify the risk factors for febrile urinary tract infection (fUTI) after ureterorenoscopic lithotripsy (URSL) and to clarify the significance of obtaining a postoperative urine culture.
Objectives and Methods
The subjects were 303 patients who underwent URSL and a postoperative urine culture after the URSL between 2016 and 2017 at Abiko Toho Hospital. The specimen for the postoperative urine culture was obtained via the urethral catheter on the morning after the URSL and was considered as positive when the bacterial count in the urine sample was determined to be more than 104 CFU/mL. The patient data, including the isolated bacteria, antimicrobial agents used, background characteristics of the patients, postoperative course, and postoperative development of fUTI were retrospectively investigated.
Results
Among the 303 cases examined, fUTI occurred in 33 patients (10.9%). The identified risk factors for fUTI were preoperative fUTI, renal rather than ureteral stone, large size of the calculi, and residual stone fragments after URSL. Among patients with a negative postoperative urine culture, the risk of postoperative fUTI was significantly higher in the cohort with comorbidities. The postoperative urine culture was positive in 17 patients (5.6%). Among the 17 patients, the preoperative urine culture was negative in 6 patients and positive in 11 patients; the same bacteria were isolated in 5 patients before and after the URSL. Postoperative fUTI occurred in 5 patients with a positive postoperative urine culture, an incidence rate (29.4%) that was significantly higher than that in patients with a negative postoperative urine culture (9.8%, p=0.0028). Out of the 5 patients with postoperative fUTI, 4 patients had residual stone fragments after the URSL. Furthermore, out of the 7 patients with residual stone fragments after URSL, 4 developed fUTI.
Discussion
The incidence of fUTI was significantly higher (29.4%) in the patients with a positive postoperative urine culture than in those with a negative postoperative urine culture (9.8%). Postoperative urine culture is not necessary after every URSL, however, it might be worthwhile obtaining samples for urine culture in patients with a high risk of fUTI, such as those with preoperative fUTI, renal rather than ureteral stone, large size of the calculi, residual stone fragments after URSL, and/or comorbidities.

Key word

urine culture, urolithiasis, ureterorenoscopic lithotripsy, postoperative infection, antimicrobial agent

Received

November 22, 2019

Accepted

June 3, 2020

Jpn. J. Chemother. 68 (5): 576-583, 2020