The Value Of Urine And Stone Culture In The Prediction Of Urosepsis Caused By PCNL

Purpose:Analysis the correlation between urine,stone culture and urinary sepsis in patients with upper urinary tract calculi treated with PCNL,and discuss the risk factors for urosepsis.Method:Patients with upper urinary tract calculi and decided to treat with PCNL in our in our department from May 2011 to October 2014 were included.All the patients took preoperative midstream urine, renal pelvis urine and stones for bacterial culture,the postoperative condition like urine routine,blood routine,urine culture,blood culture and body temperature would be monitored to evaluate the postoperative complications like fever,SIRS and severe urosepsis.Results:484 patients included in this study, the positive rate of midstream urine,pelvic urine and stone were 19.42%,4.75% and 26.65%,respectively.Statistical correlation existed among urine and stone culture.11 patients got positive urine and stone culture in the same time,7 of them with the same germ growth.Escherichia coli was the most common bacteria in preoperative urine(29.79%) and stone culture(13.04%),and pseudomonas aeruginosa was the main germs in renal pelvic urine(17.39%).Urine and stone got higher positive rate in group with fever,SIRS and severe urosepsis.The incidence of postoperative fever,SIRS, severe urosepsis in patients with positive midstream urine were 38.30%,24.47% and 7.45%,,which were 56.52%,47.83%,8.7% in positive pelvic urine patients,and were 35.66%,20.93%,5.43% in positive stone culture patients,the incidence were higher than gourps with negative culture, significant statistical difference existed. Patients with positive urine and stone culture in the same time got significant higher incidence of postoperative urosepsis, the incidence of postoperative fever,SIRS, severe urosepsis in patient with positive midstream urine,pelvic urine and stone culture reached to 72.73%,63.64%,18.18%, respectively. The risk factors affect postoperative urosepsis were operative time, the diameter of stone, preoperative urine culture,pelvic urine culture and the stone culture.Conclusions:Urine and stone culture are relevant factor of urosepsis after PCNL,patients get a higher incidence of postoperative urosepsis with positive culture result.It has important reference value for the prediction and treatment of urosepsis to get urine and stone culture routinely in patients treated with PCNL.