Abstract

Objective: To determine the frequency of systemic inflammatory response syndrome and urosepsis after endoscopic stone surgery and to observe the stone culture and sensitivity pattern in stone disease patients.
Methodology: The study included 187 patients undergoing endoscopic surgery having negative midstream urine culture and sensitivity testing (C&S). During surgery, small fragmented stones were obtained and sent for stone C&S. Post operatively, patients were evaluated for systemic inflammatory response and urosepsis.
Results: Out of 187 patient’s, 39(20.85%) were positive. Among them 39 patients, 29(74.35%) were male 10(25.64%) female. We found 4 cases, out of 10 PCNL were positive stone C&S(40%), while 12 URS cases were positive stone C/S out of 37 (32.4%) and 23 cases of Litholapaxy 23 were positive stone C&S out of 140 (16.42%), respectively. The common organisms were E. coli 30 (76.92%), Klebsilla 4(10.24%), Proteus 3(7.69%) and Staph coagulase –ve 3(7.69%). SIRS developed in 9(4.812%) patients and urosepsis in 2(1.069%) in 187 patients, while SIRS developed in 9(23.07%) and urosepsis 2(5.12%) patients among stone C/S positive patients. Resistance was seen in Quniolone (52%), Cephlosporin (62%), Gentamycin (58%), B-lactamase (32%) and Pencillin (70%), respectively. Sensitivity was seen in Amikacin (85%), Nitrofuradantin (90%), Fosfomycin (95%), pipracillin/Tazobactum (97%) and Meronam (98%), respectively.
Conclusions: Positive stone C&S is better predictors for SIRS and urosepsis. Therefore, routine collection of stone fragments for C&S is recommended after endoscopic stone surgery.

Key words: Urolithiasis, stone culture and sensitivity, SIRS, urosepsis.