Cao Yu, Cao Hui
Ningxiang Hospital, Hunan University of Traditional Chinese Medicine Ningxiang, Changsha, Hunan, China.
Health Care Department, First Hospital of Changsha Changsha, Hunan, China.
Am J Transl Res. 2025 May 15;17(5):3658-3664. doi: 10.62347/GSAT9658. eCollection 2025.
Upper urinary tract stones are often complicated by perioperative infections. Bacterial culture analysis of calculi can reveal pathogen distribution on stone surfaces and help identify risk factors for positive culture outcomes, aiding in infection control.
A retrospective analysis was conducted on 173 patients with upper urinary tract stones who underwent holmium laser lithotripsy. Clinical characteristics potentially influencing positive stone cultures were collected and used to establish a binary logistic regression model for identifying risk factors. Additionally, the correlation between positive stone cultures and postoperative infection markers was analyzed.
Among the 173 patients, 44 had positive stone cultures, and 47 pathogen strains were detected. Forty-six patients had positive urine cultures, with 49 pathogen strains identified. The main pathogens in stone cultures were (22 strains, 46.81%), (5 strains, 10.64%), (4 strains, 8.51%), and (3 strains, 6.38%). In urine culture, the main pathogens were (26 strains, 53.06%), (5 strains, 10.2%), and (4 strains, 8.16%). Binary logistic regression identified the following risk factors for positive stone cultures: positive urine white blood cells (OR = 2.881, 95% CI = 1.070-7.760, P = 0.036), hydronephrosis (OR = 5.644, 95% CI = 2.168-14.696, P < 0.0001), struvite stones (OR = 7.512, 95% CI = 1.864-30.283, P = 0.005), and a history of diabetes (OR = 6.580, 95% CI = 1.820-23.791, P = 0.004). Spearman correlation analysis showed a strong correlation between positive stone cultures and postoperative fever (r = 0.666) and CRP failure to return to normal 48 hours post-surgery (r = 0.633), both of which were higher than the correlation with urine bacterial culture.
is the predominant pathogen in stone cultures. Risk factors for positive cultures include positive urine leukocytes, hydronephrosis, struvite stones, and a history of diabetes. Positive stone cultures are associated with a higher risk of postoperative infection compared to positive urine cultures.
上尿路结石常合并围手术期感染。结石的细菌培养分析可揭示结石表面的病原体分布，并有助于识别培养结果为阳性的危险因素，从而有助于控制感染。
对173例行钬激光碎石术的上尿路结石患者进行回顾性分析。收集可能影响结石培养阳性的临床特征，并用于建立二元逻辑回归模型以识别危险因素。此外，分析结石培养阳性与术后感染指标之间的相关性。
173例患者中，44例结石培养阳性，共检测到47株病原体。46例患者尿培养阳性，共鉴定出49株病原体。结石培养中的主要病原体为大肠埃希菌（22株，46.81%）、肺炎克雷伯菌（5株，10.64%）、粪肠球菌（4株，8.51%）和奇异变形杆菌（3株，6.38%）。尿培养中的主要病原体为大肠埃希菌（26株，53.06%）、肺炎克雷伯菌（5株，10.2%）和粪肠球菌（4株，8.16%）。二元逻辑回归确定结石培养阳性的危险因素如下：尿白细胞阳性（OR = 2.881，95%CI = 1.070 - 7.760，P = 0.036）、肾积水（OR = 5.644，95%CI = 2.168 - 14.696，P < 0.0001）、鸟粪石结石（OR = 7.512，95%CI = 1.864 - 30.283，P = 0.005）和糖尿病史（OR = 6.580，95%CI = 1.820 - 23.791，P = 0.004）。Spearman相关性分析显示结石培养阳性与术后发热（r = 0.666）以及术后48小时CRP未恢复正常（r = 0.633）之间存在强相关性，两者均高于与尿细菌培养的相关性。
大肠埃希菌是结石培养中的主要病原体。培养阳性的危险因素包括尿白细胞阳性、肾积水、鸟粪石结石和糖尿病史。与尿培养阳性相比，结石培养阳性与术后感染风险更高相关。
