Evaluating factors that dictate struvite stone composition: A multi-institutional clinical experience from the EDGE Research Consortium.
Introduction: Struvite stones account for 15% of urinary calculi and are typically associated with urease-producing urinary tract infections and carry significant morbidity. This study aims to characterize struvite stones based on purity of stone composition, bacterial spéciation, risk factors, and...
| Publicado en: | Canadian Urological Association Journal Vol. 12; no. 4; pp. 131 - 137 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Canadian Urological Association
Apr2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129316906&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129316906 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19116470 8WL9 jtl: Canadian Urological Association Journal issn: 19116470 maglogo: N pubinfo: dt: Apr2018 vid: 12 iid: 4 pid: 38993 pub: Canadian Urological Association place: Dorval, Quebec artinfo: ui: 129316906 10.5489/cuaj.4804 129316906 ppf: 131 ppct: 6 formats: tig: atl: Evaluating factors that dictate struvite stone composition: A multi-institutional clinical experience from the EDGE Research Consortium. aug: au: Flannigan, Ryan K. Battison, Andrew De, Shubha Humphreys, Mitchell R. Bader, Markus Lellig, Ekaterina Monga, Manoj Chew, Ben H. Lange, Dirk affil: The Stone Centre at Vancouver General Hospital, Department of Urologie Sciences, University of British Columbia, Vancouver BC, Canada sug: ab: Introduction: Struvite stones account for 15% of urinary calculi and are typically associated with urease-producing urinary tract infections and carry significant morbidity. This study aims to characterize struvite stones based on purity of stone composition, bacterial spéciation, risk factors, and clinical features. Methods: Retrospective data was collected from patients diagnosed with infection stones between 2008 and 2012. Stone analysis, perioperative urine cultures, bacterial spéciation, and clinical data were collected and analyzed. The purity of struvite stones was determined. Statistical comparisons were made among homogeneous and heterogeneous struvite stones. Results: From the four participating centres, 121 struvite stones were identified. Only 13.2% (16/121) were homogenous struvite. Other components included calcium phosphate (42.1%), calcium oxalate (33.9%), calcium carbonate (27.3%), and uric acid (5.8%). Partial or full staghorn calculi occurred in 23.7% of cases. Urease-producing bacteria were only present in 30% of cases. Proteus, E. coli, and Enterococcus were the most common bacterial isolates from perioperative urine, and percutaneous nephrolithotomy was the most common modality of treatment. Only 40% of patients had a urinalysis that was nitrite-positive, indicating that urinalysis alone is not reliable for diagnosing infection stones. The study's limitation is its retrospective nature; as such, the optimal timing of cultures with respect to stone analysis or treatment was not always possible, urine cultures were often not congruent with stone cultures in the same patient, and our findings of E. coli commonly cultured does not suggest causation. Conclusions: Struvite stones are most often heterogeneous in composition. Proteus remains a common bacterial isolate; however, E. coli and Enterococcus were also frequently identified. This new data provides evidence that patients with struvite stones can have urinary tract pathogens other than urease-producing bacteria, thus challenging previous conventional dogma. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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