| Objective The clinical value of preoperative urine culture and intraoperative bacterial culture of calculi in patients undergoing surgical treatment of urinary calculi was investigated by collecting preoperative urine culture and intraoperative bacterial culture of calculi from patients admitted to Baogang Hospital from November 2020 to January 2022.Methods A retrospective analysis was performed on 120 patients(86 males and 34 females)who received urolithiasis surgery in Baogang Hospital from November 2020 to January 2022.The patients’ age ranged from 25 to 78 years,with an average of(54.18±12.45)years.The preoperative mid-stream urine and intraoperative stones of all patients were collected for bacterial culture,and the results of blood glucose,blood pressure,blood lipids,body mass index,liver function,kidney function,blood routine,urine routine,stone situation,stone location,surgical methods,surgical conditions,length of hospital stay and other results were statistically analyzed.Through univariate analysis and multivariate logistic regression analysis,ROC curve was drawn to analyze the clinical value of urine culture,intraoperative calculus bacterial culture and various indicators in the surgical treatment of urinary calculi.RESULT Among the 120 patients,12 patients were positive in preoperative urine culture,including 4 males and 8 females.There were 108 patients with negative urine culture before surgery,including 82 male patients and 26 female patients.There were 4 cases of stone culture positive,2 cases of male and 2 cases of female.According to the statistical analysis of the patients in the positive urine culture group and the negative urine culture group,the number of WBC in peripheral blood of the two groups was significantly higher in the positive urine culture group than in the negative urine culture group,and the difference was statistically significant(P < 0.05).Compared with C Reactive protein(CRP)in peripheral blood of 2 groups,the number of CRP in positive group was significantly higher than that in negative group,and the difference was statistically significant(P < 0.05).Compared with the two groups of patients with urinary nitrite,the number of patients with urinary nitrite in positive group was significantly higher than that in negative group,and the difference was statistically significant(P < 0.05).The results of multifactor logistics regression analysis showed that WBC and CRP in peripheral blood were independent risk factors affecting the results of urine culture(P < 0.05).Among them,the area under the curve(AUC)of peripheral blood WBC was 0.533,and that of CRP was 0.983,indicating that the predictive performance of blood CRP on positive stone culture was better than that of blood WBC.According to the statistical analysis of the CRP results of the two groups,the number of CRP in the positive group of stone culture was significantly higher than that in the negative group of urinary stone culture,and the difference was statistically significant(P < 0.05).Compared with the results of the number of patients with positive urinary nitrite in the two groups,the number of patients with positive urinary nitrite in the positive group of stone culture was significantly higher than that in the negative group of stone culture,with statistical significance(P < 0.05).Compared with the results of the number of urine bacteria in the two groups,the number of urine bacteria in the positive group of stone culture was significantly higher than that in the negative group of stone culture,with statistical significance(P < 0.05).The results of multifactor logistics regression analysis showed that CRP and urine bacteria were independent risk factors for calculi culture results(P < 0.05).The area under the curve(AUC)of urinary bacteria was 0.938,and the AUC of CRP was0.734,indicating that the number of urinary bacteria was better than that of blood CRP in predicting positive calculus culture.There were 15 patients in the positive bacterial culture group,including 1 patient with positive bacteria culture in midstream urine and stone culture,105 patients with negative bacterial culture,including 60 patients with urinary tract infection indicated by increased white blood cell in urine routine,and 102 patients receiving antibiotics,among which all patients in the positive bacterial culture group received sensitive antibiotics for 7 days.Routine antibiotics were given to patients with urinary tract infection indicated by routine urinalysis 1 day before surgery and intraoperatively.Patients with no infection indicated by routine urinalysis and urine culture were given one dose of routine antibiotics preoperatively,and no postoperative urinary tract infection occurred in all patients.Conclusion 1.The proportion of patients with positive urine culture was 10%,and the proportion of patients with positive stone culture was 3%.The results of this study suggest that intraoperative bacterial culture of stones has no special value in the prevention and treatment of postoperative urinary tract infection in patients with urinary stones.2.Among the 120 patients,the pathogenic bacteria of the positive patients in urine culture were mainly Escherichia coli,which was consistent with the culture results of specimens sent to our department by the Laboratory department of our hospital and related literature reports;3.Preoperative application of sensitive antibiotics for patients with positive urine culture can prevent severe postoperative urinary tract infection;4.Formulating appropriate surgical plans,controlling intraoperative operation time,intraoperative fluid perfusion and pressure can reduce the incidence of severe urinary tract infection after urolithiasis in clinical practice. |
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