Vol. 4, Issue 10 (2018)
The pattern of microbial infection in patients with upper urinary tract stone disease: A prospective study
Author(s): Barua Sasanka Kumar, Das Nabajeet, Baruah Saumar Jyoti, TP Rajeev, Bagchi Puskal Kumar, Sarma Debanga, Phukan Mandeep
Abstract: Introduction: The contribution of bacteria in the pathogenesis of stone formation is a well-established fact. The incidence of SIRS increases when there is both positive urine culture and positive stone culture in comparison when one of them is absent. We aimed to analyse and find a correlation between stone composition, stone microbial profile and urine microbial profile in these patients. Materials and methods: It was a prospective study conducted from March 2015 to February 2018. Preoperative urine cultures were done routinely in all the patients. The stone analysis was done using FTIR (Fourier Transform Infrared Spectroscopy). Urinary microbial floras, stone microbial pattern and stone composition were correlated. Results and observation: The average age was 45.8 years and male to female ratio of 2.53: 1. Preoperative urine culture was positive in 60.34% of female patients and 46.94% of male patients (p=0.084). Infected stones were higher in female patients (p=0.0295). Preoperative urine culture and stone culture were positive in 50.73% and 39.5% of patients respectively. In urine culture E.coli was the most common bacteria (40.38%) (p=0.0029). The most common bacteria in stone culture in our series were Pseudomonas spp. (40.74%). Conclusion: Is it important to culture stones? We observed that more than one-tenth of patients had only positive stone culture but sterile urine culture. We found E.coli as most common organism isolated in preoperative culture while Pseudomonas was the most common in stone culture. This discrepancy should be in mind while treating a stone patient of postoperative urosepsis, who is not responding to sensitive antibiotics according to urine culture.