Litiasis renal coraliforme tratada con ondas de choque: aspectos bacteriológicos / Coraliform renal lithiasis treated with shockwaves: bacteriologic aspects

Se estudió mediante urocultivos pre y post-ESWL (litotricia extracorpórea con ondas de choque) y hemocultivos a pacientes, con cálculos coraliformes y sin signos clínicos de infección urinaria. Se incorporaron al estudio 80 pacientes adultos, 47 del sexo femenino y 33 del sexo masculino. A los 50 primeros pacientes se les tomaron 3 muestras de hemocultivos, durante el procedimiento. Los 150 hemocultivos fueron negativos y ninguno de los 80 pacientes tuvo fiebre, escalofríos e temblores durante el ESWL. Cuarenta y dos pacientes presentaron urocultivo pre-ESWL positivo (52,5 por ciento) con un total de 43 especies bacterianas, ya que hubo un caso con infección mixta. Se aislaron 49 especies bacterianas en 48 urocultivos positivos post-ESWL (60 por ciento. Seis casos presentaron bacteriuria post-ESWL que no había estado presente en el examen pre-ESWL. Los hallazgos bacteriológicos pre-post-ESWL fueron: Proteus mirabilis (22/22). E. coli (11/11), P. aeruginosa (4/5), Klebsiella pneumoniae (2/2). Enterobacter cloacae (0/1), Alcaligenes odorans (1/2), Enterococcus faecalis (1/3), Staphylococcus saprophyticus (1/2) y Candida albicans (1/1). En total 43/49, y la diferencia fueron 6 especies bacterianas. De acuerdo con nuestros resultados el riesgo de bacteriemia para este grupo sería muy bajo. En el 60 por ciento de los cálculos coraliformes se pudo demostrar una infección bacteriana

Litiasis renal coraliforme tratada con ondas de choque: aspectos bacteriológicos / Coraliform renal lithiasis treated with shockwaves: bacteriologic aspects

Se estudió mediante urocultivos pre y post-ESWL (litotricia extracorpórea con ondas de choque) y hemocultivos a pacientes, con cálculos coraliformes y sin signos clínicos de infección urinaria. Se incorporaron al estudio 80 pacientes adultos, 47 del sexo femenino y 33 del sexo masculino. A los 50 primeros pacientes se les tomaron 3 muestras de hemocultivos, durante el procedimiento. Los 150 hemocultivos fueron negativos y ninguno de los 80 pacientes tuvo fiebre, escalofríos e temblores durante el ESWL. Cuarenta y dos pacientes presentaron urocultivo pre-ESWL positivo (52,5 por ciento) con un total de 43 especies bacterianas, ya que hubo un caso con infección mixta. Se aislaron 49 especies bacterianas en 48 urocultivos positivos post-ESWL (60 por ciento. Seis casos presentaron bacteriuria post-ESWL que no había estado presente en el examen pre-ESWL. Los hallazgos bacteriológicos pre-post-ESWL fueron: Proteus mirabilis (22/22). E. coli (11/11), P. aeruginosa (4/5), Klebsiella pneumoniae (2/2). Enterobacter cloacae (0/1), Alcaligenes odorans (1/2), Enterococcus faecalis (1/3), Staphylococcus saprophyticus (1/2) y Candida albicans (1/1). En total 43/49, y la diferencia fueron 6 especies bacterianas. De acuerdo con nuestros resultados el riesgo de bacteriemia para este grupo sería muy bajo. En el 60 por ciento de los cálculos coraliformes se pudo demostrar una infección bacteriana (AU)

[Staghorn renal lithiasis treated with shock waves. Bacteriologic aspects]. / Litiasis renal coraliforme tratada con ondas de choque. Aspectos bacteriológicos.

Struvite renal stones are caused by infection of the urine with bacteria that synthesize the enzyme urease. Ammonium is released by the breakdown of urea by urease, the urine becomes highly alkaline, and magnesium ammonium phosphate (struvite) and carbonate apatite crystallize. Incorporation of the infecting bacteria within the developing stone, results in a focus of infection that is resistant to conventional antimicrobial therapy, and which is manifested clinically by repeated urinary tract infection caused by persistent bacteriuria. Extracorporeal shock wave lithotripsy (ESWL) currently is accepted as the election treatment for most renal calculi. This trial examines the bacteriologic aspects pre and post-ESWL. Eighty adult patients, 47 females and 33 males, without clinical signs of urinary tract infections (UTI) were submitted to urine cultures pre and post-ESWL. The first 50 patients underwent during and post-ESWL, 150 blood cultures, which all proved to be negative, confirming very low risk of generalized sepsis. No patient presented fever, chills or rigors pre or postprocedures. With respect to urine cultures 43 patients (52.5%) had a pre-ESWL UTI, in comparison to 49 (60%) who had a UTI post-ESWL. The distribution of organisms pre and post-ESWL was as follows: Proteus mirabilis (22/22), Escherichia coli (11/11), Pseudomonas aeruginosa (4/5), Klebsiella pneumoniae (2/2), Enterobacter cloacae (0/1), Alcaligenes odorans (1/2) Enterococcus faecalis (1/3), Staphylococcus saprophyticus (1/2) and Candida albicans (1/1). In this study 6 patients presented bacteriuria post-ESWL probably due to bacteria from inside the calculi. According to these results, the risk of bacteremia seems to be very low. In 60% of staghorn renal stones we could demonstrate a bacterial infection.

Litiasis renal coraliforme tratada con ondas de choque. Aspectos bacteriológicos. / [Staghorn renal lithiasis treated with shock waves. Bacteriologic aspects]

Struvite renal stones are caused by infection of the urine with bacteria that synthesize the enzyme urease. Ammonium is released by the breakdown of urea by urease, the urine becomes highly alkaline, and magnesium ammonium phosphate (struvite) and carbonate apatite crystallize. Incorporation of the infecting bacteria within the developing stone, results in a focus of infection that is resistant to conventional antimicrobial therapy, and which is manifested clinically by repeated urinary tract infection caused by persistent bacteriuria. Extracorporeal shock wave lithotripsy (ESWL) currently is accepted as the election treatment for most renal calculi. This trial examines the bacteriologic aspects pre and post-ESWL. Eighty adult patients, 47 females and 33 males, without clinical signs of urinary tract infections (UTI) were submitted to urine cultures pre and post-ESWL. The first 50 patients underwent during and post-ESWL, 150 blood cultures, which all proved to be negative, confirming very low risk of generalized sepsis. No patient presented fever, chills or rigors pre or postprocedures. With respect to urine cultures 43 patients (52.5

) had a pre-ESWL UTI, in comparison to 49 (60

) who had a UTI post-ESWL. The distribution of organisms pre and post-ESWL was as follows: Proteus mirabilis (22/22), Escherichia coli (11/11), Pseudomonas aeruginosa (4/5), Klebsiella pneumoniae (2/2), Enterobacter cloacae (0/1), Alcaligenes odorans (1/2) Enterococcus faecalis (1/3), Staphylococcus saprophyticus (1/2) and Candida albicans (1/1). In this study 6 patients presented bacteriuria post-ESWL probably due to bacteria from inside the calculi. According to these results, the risk of bacteremia seems to be very low. In 60

of staghorn renal stones we could demonstrate a bacterial infection.