Assessment of the incidence and risk factors of postoperative urosepsis in patients undergoing ureteroscopic lithotripsy.

Autor:	Kaczmarek K; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Jankowska M; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Kalembkiewicz J; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Kienitz J; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Chukwu O; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Lemiński A; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Słojewski M; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland.
Jazyk:	angličtina
Zdroj:	Central European journal of urology [Cent European J Urol] 2024; Vol. 77 (1), pp. 122-128. Date of Electronic Publication: 2024 Jan 08.
DOI:	10.5173/ceju.2023.167
Abstrakt:	Introduction: Ureteroscopic lithotripsy (URSL) is an approved, minimally invasive, low-risk procedure for urolithiasis treatment. However, some patients may develop urinary tract infection (UTI) post-procedure, eventually leading to urosepsis. Determining the predictors of infection after URSL would help identify patients at a high risk of urosepsis, thereby enabling the early implementation of effective treatment. Therefore, we aimed to establish the incidence and predictors of urosepsis after URSL. Material and Methods: We assessed 231 patients who underwent URSL using a holmium laser. The incidence of urosepsis during the 30-day post-treatment period was analysed, and potential predictors of urosepsis, including patient characteristics and individual clinical factors, were examined. Results: Statistical analysis revealed that 16.88% of patients had a confirmed positive urine culture before the procedure. Post-procedure urosepsis occurred in 4.76% of patients. Univariable analysis revealed that 3 factors were significantly associated with the risk of postoperative urosepsis: double-J stent insertion before URSL, pre-operative positive urine culture, and MDR pathogen found preoperatively. In multivariable analysis, only positive urine culture remained significantly associated with the risk of urosepsis after URSL. Conclusions: Patients with positive urine culture before URSL are at significantly higher risk of urosepsis in the postoperative period. Hence, urine culture should be routinely performed before planned endoscopic urolithiasis treatment. Competing Interests: The authors declare no conflicts of interest. (Copyright by Polish Urological Association.)
Databáze:	MEDLINE
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