Post-PCNL sepsis is more likely with MDR bacteriuria

  • Gao X & al.
  • World J Urol
  • 9 Apr 2019

  • International Clinical Digest
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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%.