Asymptomatic bacteriuria in candidates for active treatment of renal stones: results from an international multicentric study on more than 2600 patients.
Asymptomatic bacteriuria
Preoperative
Risk factors
Urine culture
Urolithiasis
Journal
Urolithiasis
ISSN: 2194-7236
Titre abrégé: Urolithiasis
Pays: Germany
ID NLM: 101602699
Informations de publication
Date de publication:
13 Dec 2022
13 Dec 2022
Historique:
received:
22
07
2022
accepted:
17
11
2022
entrez:
13
12
2022
pubmed:
14
12
2022
medline:
16
12
2022
Statut:
epublish
Résumé
The occurrence of asymptomatic bacteriuria concomitant to urolithiasis is an issue for patients undergoing renal stone treatment. Disposing of a preoperative urine culture is essential to reduce the risk of septic events. The endpoint of the study is to report which characteristics of candidates for renal stone treatment are frequently associated with positive urine culture. 2605 patients were retrospectively enrolled from 14 centers; inclusion criteria were age > 18 and presence of a single renal stone 1-2 cm in size. The variables collected included age, gender, previous renal surgery, comorbidities, skin-to-stone distance, stone size, location, density, presence of hydronephrosis. After a descriptive analysis, the association between continuous and categorical variables and the presence of positive urine culture was assessed using a logistic regression model. Overall, 240/2605 patients (9%) had preoperative bacteriuria. Positive urine culture was more frequent in females, patients with previous renal interventions, chronic kidney disease, congenital anomalies, larger stones, increased density. Multivariate analysis demonstrated that previous renal interventions (OR 2.6; 95% CI 1.9-3.4; p < 0.001), renal-related comorbidities (OR 1.31; 95% CI 1.19-1.4; p < 0.001), higher stone size (OR 1.06; 95% CI 1.02-1.1; p = 0.01) and density (OR 1.00; 95% CI 1.0-1.00; p = 0.02) were associated with bacteriuria; male gender and lower caliceal location were inversely related to it. Beyond expected risk factors, such as female gender, other parameters are seemingly favoring the presence of positive urine culture. The awareness of variables associated with bacteriuria allows to assess which individuals are at increased risk of presenting bacteriuria and reduce the rate of septic complications.
Identifiants
pubmed: 36512096
doi: 10.1007/s00240-022-01385-4
pii: 10.1007/s00240-022-01385-4
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
16Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
A. Skolarikos, A. Neisius, A. Petřík, et al. (2022) EAU Guidelines on Urolithiasis. EAU Guidelines. https://uroweb.org/guidelines/urolithiasis
Mariappan P, Smith G, Bariol SV, Moussa SA, Tolley DA (2005) Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J Urol 173(5):1610–1614. https://doi.org/10.1097/01.ju.0000154350.78826.96
doi: 10.1097/01.ju.0000154350.78826.96
pubmed: 15821509
Gravas S, Montanari E, Geavlete P, Onal B, Skolarikos A, Pearle M, Sun YH, de la Rosette J (2012) Postoperative infection rates in low-risk patients undergoing percutaneous nephrolithotomy with and without antibiotic prophylaxis: a matched case control study. J Urol 188(3):843–847. https://doi.org/10.1016/j.juro.2012.05.007
doi: 10.1016/j.juro.2012.05.007
pubmed: 22819398
Guliev BG, Zaikin AY, Ismatii O (2018) The infective complications of the percutaneous nephrolithotomy. Urologiia 5:128–133 (PMID: 30575363)
doi: 10.18565/urology.2018.5.128-133
Wollin DA, Joyce AD, Gupta M, Wong MYC, Laguna P, Gravas S, Gutierrez J, Cormio L, Wang K, Preminger GM (2017) Antibiotic use and the prevention and management of infectious complications in stone disease. World J Urol 35(9):1369–1379. https://doi.org/10.1007/s00345-017-2005-9
doi: 10.1007/s00345-017-2005-9
pubmed: 28160088
Shigeta M, Hayashi M, Igawa M (1995) A clinical study of upper urinary tract calculi treated with extracorporeal shock wave lithotripsy: association with bacteriuria before treatment. Urol Int 54(4):214–216. https://doi.org/10.1159/000282726
doi: 10.1159/000282726
pubmed: 7610504
Cai T, Verze P, Palmieri A, Gacci M, Lanzafame P, Malossini G, Nesi G, Bonkat G, Wagenlehner FME, Mirone V, Bartoletti R, Bjerklund TE, Johansen, (2017) Is preoperative assessment and treatment of asymptomatic bacteriuria necessary for reducing the risk of postoperative symptomatic urinary tract infections after urologic surgical procedures? Urology 99:100–105. https://doi.org/10.1016/j.urology.2016.10.016
doi: 10.1016/j.urology.2016.10.016
pubmed: 27773650
Micali S, Sighinolfi MC, Iseppi A, Morini E, Calcagnile T, Benedetti M, Ticonosco M, Kaleci S, Bevilacqua L, Puliatti S, De Nunzio C, Arada R, Chiancone F, Campobasso D, Eissa A, Bonfante G, Simonetti E, Cotugno M, Galli R, Curti P, Schips L, Ditonno P, Villa L, Ferretti S, Bergamaschi F, Bozzini G, Zoeir A, El Sherbiny A, Frattini A, Fedelini P, Okhunov Z, Tubaro A, Landman J, Bianchi G, Rocco B (2022) Initial experience and evaluation of a nomogram for outcome prediction in management of medium-sized (1–2 cm) kidney stones. Eur Urol Focus 8(1):276–282. https://doi.org/10.1016/j.euf.2020.12.012
doi: 10.1016/j.euf.2020.12.012
pubmed: 33419709
G. Bonkat (Chair), R. Bartoletti, F. Bruyère, T. Cai, S.E. Geerlings, B. Köves, S. Schubert, A. Pilatz, R. Veeratterapillay, F. Wagenlehner Guidelines Associates: W. Devlies, J. Horváth, G. Mantica, T. Mezei, B. Pradere (2021) EAU Guidelines on Urological Infections. EAU Guidelines. https://uroweb.org/guidelines/urological-infections
Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM (2005) Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 40(5):643–654. https://doi.org/10.1086/430760
doi: 10.1086/430760
pubmed: 15714408
Kunin CM, McCormack RC (1968) An epidemiologic study of bacteriuria and blood pressure among nuns and working women. N Engl J Med 278(12):635–642
doi: 10.1056/NEJM196803212781201
pubmed: 4866351
Zhanel GG, Nicolle LE, Harding GK (1995) Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. Clin Infect Dis 21(2):316–322. https://doi.org/10.1093/clinids/21.2.316
doi: 10.1093/clinids/21.2.316
pubmed: 8562738
Zhanel GG, Harding GK, Nicolle LE (1991) Asymptomatic bacteriuria in patients with diabetes mellitus. Rev Infect Dis 13(1):150–154. https://doi.org/10.1093/clinids/12.5.150
doi: 10.1093/clinids/12.5.150
pubmed: 2017615
Stamm WE (1991) Catheter-associated urinary tract infections: epidemiology, pathogenesis, and prevention. Am J Med 91(3B):65S-71S. https://doi.org/10.1016/0002-9343(91)90345-X
doi: 10.1016/0002-9343(91)90345-X
pubmed: 1928194
Carbone A, Salhi YA, Tasca A, Palleschi G, Fuschi A, De Nunzio C, Bozzini G, Mazzaferro S, Pastore AL (2018) Obesity and kidney stone disease: a systematic review. Minerva Urol Nefrol 70(4):393–400. https://doi.org/10.23736/S0393-2249.18.03113-2
doi: 10.23736/S0393-2249.18.03113-2
pubmed: 29856171
Witting C, Langman CB, Assimos D, Baum MA, Kausz A, Milliner D, Tasian G, Worcester E, Allain M, West M, Knauf F, Lieske JC (2021) Pathophysiology and treatment of enteric hyperoxaluria. Clin J Am Soc Nephrol 16(3):487–495. https://doi.org/10.2215/CJN.08000520
doi: 10.2215/CJN.08000520
pubmed: 32900691
Park JH, Jo Y-I, Lee J-H (2020) Renal effects of uric acid: hyperuricemia and hypouricemia. Korean J Intern Med 35(6):1291–1304. https://doi.org/10.3904/kjim.2020.410
doi: 10.3904/kjim.2020.410
pubmed: 32872730
pmcid: 7652664
Lojanapiwat B (2006) Colonization of internal ureteral stent and bacteriuria. World J Urol 24(6):681–683. https://doi.org/10.1007/s00345-006-0135-6
doi: 10.1007/s00345-006-0135-6
pubmed: 17094007
Miano R, Germani S, Vespasiani G (2007) Stones and urinary tract infections. Urol Int 79:32–36. https://doi.org/10.1159/000104439
doi: 10.1159/000104439
pubmed: 17726350
Hugosson J, Grenabo L, Hedelin H, Lincolon K, Pettersson S (1989) Chronic urinary tract infection and renal stones. Scand J Urol Nephrol 23(1):61–66. https://doi.org/10.1080/00365599.1989.11690432
doi: 10.1080/00365599.1989.11690432
pubmed: 2646704