Login to Access Video or Poster Abstract: MP75-11
Sources of Funding: none

Introduction

Septicemia is a serious complication following percutaneous nephrolithotomy(PCNL) and can occur inspite of sterile preoperative urine culture and prophylactic antibiotics. The aim of the study was to analyze the utility of cultures of mid stream urine(MSU), renal pelvic urine and crushed stones for prediction of urosepsis

Methods

We performed a prospective clinical study in consecutive patients undergoing PCNL between April 2015 and Oct 2015. The samples collected for culture and sensitivity (C&S) were 1) MSU one day before surgery, 2) Urine from pelvicaliceal system during percutaneous puncture, and 3) Stone fragments collected during the procedure.All the patients were monitored in the postoperative period for symptoms and signs of urosepsis. The data collected were divided into 3 main groups MSU C&S, pelvic urine C&S and stone C&S and analyzed to determine association with urosepsis.

Results

A total of 83 patients were included. The MSU C&S was positive in 10.8%, pelvic C&S in 13.7% and stone C&S in 30.1% patients. 20 patients had systemic inflammatory response syndrome (SIRS) and 3 patients had septic shock. Out of the 20 with SIRS, 17 cases were stone C&S positive, 6 were pelvic urine C&S positive and 2 patients had positive MSU C&S

Conclusions

Stone C&S is a better predictor of potential urosepsis than pelvic urine and MSUC &S which often fail to grow stone colonizing bacteria. We recommend routine collection of stone for C&S for the diagnosis and management of urosepsis after PCNL.

Funding

none