The occurrence of asymptomatic bacteriuria concomitant to urolithiasis is an issue for patients undergoing renal stone treatment. Disposing of a preoperative urine culture is essential to reduce the risk of septic events. The endpoint of the study is to report which characteristics of candidates for renal stone treatment are frequently associated with positive urine culture. 2605 patients were retrospectively enrolled from 14 centers; inclusion criteria were age > 18 and presence of a single renal stone 1-2 cm in size. The variables collected included age, gender, previous renal surgery, comorbidities, skin-to-stone distance, stone size, location, density, presence of hydronephrosis. After a descriptive analysis, the association between continuous and categorical variables and the presence of positive urine culture was assessed using a logistic regression model. Overall, 240/2605 patients (9%) had preoperative bacteriuria. Positive urine culture was more frequent in females, patients with previous renal interventions, chronic kidney disease, congenital anomalies, larger stones, increased density. Multivariate analysis demonstrated that previous renal interventions (OR 2.6; 95% CI 1.9-3.4; p < 0.001), renal-related comorbidities (OR 1.31; 95% CI 1.19-1.4; p < 0.001), higher stone size (OR 1.06; 95% CI 1.02-1.1; p = 0.01) and density (OR 1.00; 95% CI 1.0-1.00; p = 0.02) were associated with bacteriuria; male gender and lower caliceal location were inversely related to it. Beyond expected risk factors, such as female gender, other parameters are seemingly favoring the presence of positive urine culture. The awareness of variables associated with bacteriuria allows to assess which individuals are at increased risk of presenting bacteriuria and reduce the rate of septic complications.
Urolithiasis. 2022 Dec 13*** epublish ***
T Calcagnile, M C Sighinolfi, B Rocco, S Assumma, S Di Bari, E Panio, A Pescuma, M Ticonosco, G Tosi, P Oltolina, S Resca, S Kaleci, R Galli, P Curti, L Schips, P Ditonno, L Villa, S Ferretti, F Bergamaschi, G Bozzini, A Eissa, A Zoeir, A El Sherbiny, A Frattini, A Prati, P Fedelini, Z Okhunov, A Tubaro, J Landman, G Bianchi, S Puliatti, S Micali
Department of Urology, University of Modena and Reggio Emilia, Modena, Italy. ., Department of Urology, ASST Santi Paolo e Carlo-University of Milan, Milan, Italy., Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Clinical and Experimental Medicine (CEM), Department of Surgical, Medical, Dental and Morphological Sciences With Interest in Transplant, Oncology and Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy., Department of Urology, Policlinico San Pietro, Ponte San Pietro, Italy., Ospedale "Mater Salutis"-AULSS 9 Scaligera, Verona, Italy., Department of Urology, Ospedale SS. Annunziata, Chieti, Italy., Department of Urology, University of Bari, Bari, Italy., Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy., Department of Urology, Ospedale Maggiore, Parma, Italy., Department of Urology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy., Department of Urology, Ospedale Sant'Anna, Como, Italy., Department of Urology, Tanta University, Tanta, Egypt., Department of Urology, Ospedale Civile di Guastalla, Guastalla, Italy., Department of Urology, Ospedale di Vaio, Fidenza, Italy., Department of Urology, AORN Antonio Cardarelli, Naples, Italy., Department of Urology, University of California, Irvine, CA, USA., Department of Urology, Ospedale Sant'Andrea, la Sapienza" University, Rome, Italy.