Takeaway
- Patients with struvite stones who test positive for multidrug-resistant (MDR) bacteriuria or increased serum creatinine (Cr) are more likely to develop sepsis after percutaneous nephrolithotomy (PCNL).
Why this matters
- Providers should exercise extra caution when managing patients with struvite stones undergoing PCNL.
Study design
- Researchers studied the health records of patients who underwent PCNL (n=194; mean age, 49.01 years; 51.03% women; mean BMI, 23.76±3.43 kg/m2), comparing data for those who had struvite stones (50%) and those who had other stone types.
- Funding: National Natural Science Foundation of China; National Key R&D Program of China.
Key results
- Patients with struvite stones were more likely to have a history of urolithiasis surgery (56.70%), preoperative broad-spectrum antibiotic therapy (53.61%), positive preoperative urine culture (55.67%), and sepsis after surgery (35.05%; P<.05 for all>
- Multivariate analysis revealed 2 independent risk factors for postoperative sepsis:
- Preoperative MDR bacteriuria: OR, 3.203 (P=.043); and
- Increased serum Cr: OR, 3.963 (P =.010).
Limitations
- The study was single-center, single-surgeon, and retrospective and had a small sample size.
- Results may not apply to patients with higher BMIs or E coli bacteriuria >20%.
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