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Importance of microbiological evaluation in management of infectious complications following percutaneous nephrolithotomy

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Abstract

Aim

To evaluate the infectious complications, microorganism distribution and antibacterial treatment in patients who underwent percutaneous nephrolithotomy (PCNL).

Patients and methods

Three hundred and thirty-eight patients who were 17 years age or older who underwent PCNL between January 2001 and December 2002 have been evaluated retrospectively. Urine cultures obtained before, during and after PCNL and cultures of stone fragments, extracted during PCNL, were analyzed. Eighty-two patients, who have been referred to Section of infectious disease because of postoperative fever (Group 1; 58 males, 24 females, mean age: 45.5 years) and the remainder of patients (Group 2; 169 males, 87 females, mean age: 44.5 years) were compared in regard to infectious complications and microbiological culture results.

Results

The evaluation of peroperative urine cultures revealed that patients in Group 1 had more positive urine cultures than the other group. The analysis showed fever developed more frequently in patients with positive stone cultures and also in patients with positive peroperative urine. Overall, during the study period, five of 338 (1.5%) patients developed sepsis and none of them was lost due to sepsis. Comparison of two groups revealed that patients in Group 1 had a larger stone burden, longer operative time and longer postoperative hospital stay than patients in Group 2.

Conclusion

Fever and bacteriemia after PCNL are common, through progression to sepsis is rare. Recovery is possible with a high degree of suspicion, early intervention and intensive treatment. The results of cultures taken preoperatively, peroperatively and during the febrile period have great importance for decision of required changes during the treatment.

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References

  1. McDougall EM, Liatsikos EN, Dinlenc CZ, Smith AD (2002) Percutaneous approaches to the upper urinary tract. In Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds) Campbell’s Urology, 8th edn. W.B. Saunders Company, Philadelphia, Pennsylvania, pp 3327–3452

    Google Scholar 

  2. Cadeddu JA, Chen R, Bishoff J, Micali S, Kumar A, Moore RG, Kavoussi LR (1998) Clinical significance of fever after percutaneous nephrolithotomy. Urology 52(1):48–50

    Article  PubMed  CAS  Google Scholar 

  3. Rao PN, Dube DA, Weightman NC, Oppenheim BA, Morris J (1991) Prediction of septicemia following endourologic manipulation for stones in the upper urinary tract. J Urol 146:955–960

    PubMed  CAS  Google Scholar 

  4. Charton M, Vallencien G, Veillon B, Brisset JM (1986) Urinary tract infection in percutaneous surgery for renal calculi. J Urol 135:15–17

    PubMed  CAS  Google Scholar 

  5. Naomi PO, Barie PS, Bartlett TB, et al (1998) Practice guidelines for evaluating new fever in critically ill adult patients. Clin Infect Dis 26:1042–1059

    Google Scholar 

  6. Bone RC, Balk RA, Cerra FB, et al. (1992) American college of chest physicians/society of critical care medicine consensus conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874

    Article  Google Scholar 

  7. Dogan HS, Sahin A, Cetinkaya Y, Akdogan B, Ozden E, Kendi S (2002) Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients. J Endourol 16(9):649–653

    Article  PubMed  Google Scholar 

  8. Shenep JL, Morgan KA (1984) Kinetics of endotoxin release during antibiotic therapy for experimental gram-negative sepsis. J Infect Dis 150:380–388

    PubMed  CAS  Google Scholar 

  9. Troxel SA, Low KR (2002) Renal intrapelvic pressure during percutaneous nephrolithotomy and its correlation with the development of postoperative fever. J Urol 168:1348–1351

    Article  PubMed  Google Scholar 

  10. O’Keefe NK, Mortimer AJ, Sambrook PA, Rao PN (1993) Severe sepsis following percutaneous or endoscopic procedures for urinary tract stones. Br J Urol 72:277–283

    Google Scholar 

  11. McAleer IM, Kaplan GW, Bradley JS, Carroll SF, Griffith DP (2003) Endotoxin content in renal calculi. J Urol 169:1813–1814

    Article  PubMed  CAS  Google Scholar 

  12. Takeuchi H, Ueda M, Nonomura M, Hida S, Oishi K, Higashi Y, Okada Y, Kawamura J, Yoshida O (1987) Fever attack in percutaneous nephrolithotomy and transurethral ureterolithotripsy. Hinyokika Kiyo 33(9):1357–1363

    PubMed  CAS  Google Scholar 

  13. Scherz HC, Parsons CL (1987) Prophylactic antibiotics in Urology Urol Clin North Am 14(2):265–271

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Hacettepe University, Faculty of Medicine, Ankara, Turkey

    Hasan Serkan Dogan, Fuad Guliyev, Mustafa Sofikerim, Ender Ozden & Ahmet Sahin

  2. Department of Internal Medicine, Section of Infectious Diseases, Hacettepe University, Faculty of Medicine, Ankara, Turkey

    Yesim S. Cetinkaya

Authors
  1. Hasan Serkan Dogan
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  2. Fuad Guliyev
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  3. Yesim S. Cetinkaya
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  4. Mustafa Sofikerim
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  5. Ender Ozden
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  6. Ahmet Sahin
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Corresponding author

Correspondence to Fuad Guliyev.

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Dogan, H.S., Guliyev, F., Cetinkaya, Y.S. et al. Importance of microbiological evaluation in management of infectious complications following percutaneous nephrolithotomy. Int Urol Nephrol 39, 737–742 (2007). https://doi.org/10.1007/s11255-006-9147-9

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  • DOI: https://doi.org/10.1007/s11255-006-9147-9

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