Role Of Preoperative Urine Culture Re-examination In The Prediction Of Infectious Complications Related To Mini-percutaneous Nephrolithotomy

Background and ObjectiveEffective control of urinary tract infection before operation is one of the important measures to reduce the incidence of infectious complications related to percutaneous nephrolithotomy(PCNL).For patients with positive urine culture,sensitive antibiotics are necessary,but the course and efficacy of antibiotics are controversial.The purpose of this study is to explore the role of urine culture reexamination in predicting the complications of mini-PCNL infection in patients with positive urine culture after sensitive antibiotic treatment.Patients and MethodsProspective and consecutive clinical data were collected from patients whose preoperative urine culture was positive and who underwent PCNL at the Department of Urology,the First Affiliated Hospital of Guangzhou Medical University.If patients’ preoperative urine cultures were positive,they would be treated with appropriate antibiotics in accordance with the culture-antibiogram test results,and urine cultures were repeated on day 3 and day 7.Patients would undergo mini-PCNL after in the treatment of sensitive antibiotics for 7 days,and the correlation between the results of urine culture on day 3 and day 7 and infectious complications related to mini-PCNL after surgery was analyzed.ResultsFrom March 2021 to April 2023,a total of 100 patients’ clinical data were collected.Univariate analysis showed that the factors including age,gender,diabetes history,preoperative venous leukocyte and operation time were not significantly correlated with infection complications after mini-PCNL surgery(P > 0.05).Reexamination of urine culture on the third day showed negative results in 95 cases,postoperative fever in 20 cases,including 3 cases of urosepsis,positive urine culture in 5 cases,postoperative fever in 1 case,including urosepsis in 1 case.Reexamination of urine culture on the 7th day showed negative results in 95 cases,19 cases developed fever after operation,including 4 cases of urosepsis.Urine culture was positive in 5 cases,and postoperative fever occurred in 2 cases without urosepsis.Univariate analysis showed the results of urine culture on day 3 and 7 were not significantly correlated with infection complications after mini-PCNL surgery(P >0.05).ConclusionsThe value of re-examination of urine culture in predicting postoperative infectious complications related to mini-PCNL is limited in patients with positive urine culture treated with sensitive antibiotics before surgery.For patients with positive urine culture before surgery,it is recommended to continue mini-PCNL after7 days of treatment with sensitive antibiotics.