Analysis Of Urinary Stone Composition And Infection-control From 267 Patients

Objective:Through the analysis of chemical composition of urinary calculi, we provided the evidents for further study on the diagnosis and treatment. Meanwhile, we provided reference and recommendations for the rational use of antibiotics in patients with urinary calculi complicated with urinary tract infection to explore the clinical value of urinary calculi in the prevention and treatment.Methods:The retrospectively study analyzed the data of 267 urolithiasis cases from Shandong Provincial Hospital though operation during June,2012 and June,2014, and the calculi were collected for research. Among them, the number of kidney stone, ureter stone and bladder stone was 191,65 and 11 cases separately. The technique of infrared spectrophotometry have been used to analyze the chemical components of calculi. The distribution of age, gender and position of stone have been described also. Meanwhile, we utilized the results of drug sensitivity test and the analysis of urine bacteria culture to explicit the antibacterial spectrum of urinary tract infection preliminarily.Results:The urinary calculi chemical compositions (according ratios) were calcium oxalate monohydrate (85.39%), carbonate apatite (53.93%), calcium oxalate dihydrate (52.81%), uric acid (11.24%), magnesium ammonium phosphate (6.37%), and cystine (0.75%). The detection rate of calcium oxalate monohydrate was the highest in each part of urinary system. There is no statistical difference regards to the distribution of main components in each side of the kidneys and ureters (P>0.05). Single composition type of urinary calculi accounted for 31.09%, of which calcium oxalate monohydrate was the most. Mixed composition type of urinary calculi accounted for 68.91%, of which the calculi composed of calcium oxalate monohydrate, calcium oxalate dihydrate and carbonate apatite was the most. As regard to the composition for urinary calculi, in patients with men of all age groups, the number of detected cases were more than female, except for magnesium ammonium phosphate. For patients with urinary calculi of urinary bacterial culture positive, there were 69 cases, among which Escherichia coli was the most, followed by Enterococcus faecalis, Klebsiella pneumoniae and Proteus mirabilis. Bacterial culture positive urinary calculi composition with calcium oxalate monohydrate was the most. Positive rate of female with urinary bacterial culture results (51.11%) is more than men(11.86%) (P<0.05). Antibiotics which bacillus were sensitive to were cefoxitin, cefepime, most β-lactam +β-lactamase inhibitors, carbapenems and amikacin. Antibiotics which cocci were sensitive to were furadantin, vancomycin, teicoplanin and linezolid.Conclusions:The formation of calcium oxalate monohydrate, calcium oxalate dihydrate, magnesium ammonium phosphate is related to gender. Men are more likely to form the composition of calcium oxalate stone, meanwhile, women are more likely to form the composition of magnesium ammonium phosphate. The formation of carbonate apatite and magnesium ammonium phosphate are closely related to infection. Women are more likely to suffer from infection stone. Before drug sensitivity results back to show, for the patients with urinary calculi and infection, the rational use of antibiotics has its feasibility.