EAU 2018: Clinical Relevance of the Bacteria Spread into the Irrigation Fluid During Endourological Procedures: A Novel Tool to Guide Appropriate Postoperative Antibiotic Management

Copenhagen, Denmark (UroToday.com) Stone Culture is frequently investigated following a PCNL procedure. Stone culture results have a played a big role in patient treatment plans and its correlation with risk of infections has been seen in many studies. Dr. E. De Lorenzis and team predicted that bacteria and endotoxins from stones are released during the stone fragmentation step of PCNL and sought to see if there was an association with system inflammatory response syndrome (SIRS) risk.

To assess this, Dr. Lorenzis and team tested 71 consecutive patients undergoing endourological procedures from January 2017 to September 2017 for either PCNL (43) or retrograde intrarenal surgery (28). All patients had urine cultures received from preoperative bladder urine (BUC), renal pelvic urine from renal catheter (RPUC), stone fragmentation from irrigation fluid samples (SFUC), and traditional stone culture (SC).

Once all positive cultures were analyzed, the authors found that, as in past studies, SC had the best correlation with risk of infection when compared with the other cultures. However, SFUC showed very similar results and had 93.3% concordance with SC. SIRS occurrence was associated with higher rate of both positive SFUC and SC but not BUC and RPUC.

Dr. Lorenzis concluded that SFUC is clinically relevant and similar to SC. The author added that this information may prove to be a useful alternative in patients where SC cannot be obtained due small calculi or complete dusting.

Speaker: E. De Lorenzis

Authors: Boeri L., De Lorenzis E., Gallioli A., Fontana M., Zanetti S.P., Palmisano F., Sampogna G., Longo F., Colombo R., Arghittu M., Piconi S., Salonia A., Albo G., Montanari E.

Written by: Renai Yoon, Department of Urology, University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark
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