Department of Medical Microbiology, Hitit University Erol Olcok Education and Research Hospital, Çorum, Turkey.
Department of Urology, Hitit University Erol Olcok Education and Research Hospital, 19040, Çorum, Turkey.
Urolithiasis. 2020 Apr;48(2):159-165. doi: 10.1007/s00240-019-01130-4. Epub 2019 Mar 20.
The endoscopic treatment of urolithiasis has a high success rate and the complications decreased after the development of lithotripsy techniques. The aim of this study is to investigate the in vitro bactericidal effect of laser and pneumatic lithotripsy on urinary stones colonized with Escherichia coli and Enterococcus faecalis. A total of 40 natural calcium oxalate stones, which were obtained from the patients' urinary systems with rigid ureteroscopy were used in the study. Surfaces of the stones were colonized with E. coli and E. faecalis strains. The fragmentation of the stones was performed using holmium:yttrium-aluminum-garnet laser (Ho:YAG laser) and pneumatic lithotripters in vitro in Eppendorf tubes filled with liquid. After fragmentation, samples taken from Eppendorf tubes were inoculated on blood and EMB agar. The number of colonies was evaluated after 18-24-hour incubation period. The laser lithotripsy technique reduced the number of colonies by 100% and had bactericidal effect on E. coli and E. faecalis. Pneumatic lithotripsy technique had no bactericidal effect on these strains (0%). In the fifth minute of laser irradiation, the average temperature in the Eppendorf tube was 51-55 °C, and the average temperature in the tenth minute was 54-60 °C. The temperatures did not change in the fifth and tenth minutes with the pneumatic lithotripsy procedure. The present study revealed the bactericidal effect of Ho:YAG laser on E. coli and E. faecalis in vitro. Increased ambient temperature during Ho:YAG laser lithotripsy is thought to play a role in the bactericidal effect. But the question of whether an ideal lithotripter efficiently inactivates or destroys bacteria has still not been answered in urology practice. This preliminary study showed the bactericidal effect of Ho:YAG laser lithotripsy, but further studies are needed to investigate the bactericidal effect of Ho:YAG laser in vivo.
腔内治疗尿路结石的成功率很高，并且随着碎石技术的发展，并发症也有所减少。本研究旨在探讨钬激光和气压弹道碎石术对大肠埃希菌和屎肠球菌定植的尿路结石的体外杀菌效果。共使用 40 块从患者硬镜输尿管取石术中获得的天然草酸钙结石。用大肠埃希菌和屎肠球菌菌株使结石表面定植。将结石在装满液体的 Eppendorf 管中用钬：钇-铝-石榴石激光（Ho:YAG 激光）和气压弹道碎石机进行体外粉碎。粉碎后，从 Eppendorf 管中取样本接种于血琼脂和 EMB 琼脂上。孵育 18-24 小时后评估菌落数。激光碎石术可使菌落数减少 100%，对大肠埃希菌和屎肠球菌具有杀菌作用。气压弹道碎石术对这些菌株无杀菌作用（0%）。激光照射 5 分钟时，Eppendorf 管内的平均温度为 51-55°C，10 分钟时的平均温度为 54-60°C。气压弹道碎石术在第 5 分钟和第 10 分钟时，Eppendorf 管内的温度没有变化。本研究显示 Ho:YAG 激光对大肠埃希菌和屎肠球菌具有体外杀菌作用。Ho:YAG 激光碎石过程中环境温度的升高被认为是杀菌作用的原因。但是，腔内碎石术是否能有效灭活或破坏细菌，这个问题在泌尿科实践中仍未得到解答。本初步研究显示了 Ho:YAG 激光碎石术的杀菌效果，但需要进一步研究来探讨 Ho:YAG 激光在体内的杀菌效果。
