scholarly journals The Effect of the Duration between Preoperative Bladder Urine Culture and Semirigid Ureteroscopic Lithotripsy on the Rate of Systemic Inflammatory Response Syndrome Postoperatively

2021 ◽  
Vol 2 (2) ◽  
pp. 65-69
Author(s):  
Fatih Akkas

Purpose The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome (SIRS) after semirigid ureteroscopic lithotripsy (SUL), and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods A retrospective review was conducted including patients who underwent SUL in our center between June 2015 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results The entire study included a cohort of 572 patients. The rate of SIRS following SUL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SUL when comparing the SIRS group with the other group. Conclusion The duration between PBUC and SUL is not efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issue as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture.

Author(s):  
Fatih Akkaş ◽  
Emre Sam ◽  
Ahmet Cinislioglu ◽  
İbrahim Karabulut ◽  
Fatih Kursat Yilmazel ◽  
...  

Purpose: The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome after semirigid ureteroscopic lithotripsy (SULL) , and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods: A retrospective review was conducted including patients who underwent SULL in our center between January 2011 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results: The entire study included a cohort of 572 patients. The rate of SIRS following SULL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SULL when comparing the SIRS group with the other group. Conclusion: The duration between PBUC and SULL is not an efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issues as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture


2014 ◽  
Vol 21 (1) ◽  
Author(s):  
Taufik Indrawan ◽  
Sunaryo Hardjowijoto ◽  
Doddy M. Soebadi ◽  
Juniastuti Juniastuti ◽  
Budiono Budiono

Objective: This study evaluated the correlation between preoperative urine culture and intraoperative stone culture and the impact of stone culture findings on post-operative systemic inflammatory response syndrome. Material & Method:Patients with kidney stones who underwent percutaneous nephrolithotomy (PCNL) from February to May 2012 were prospectively analyzed. A pre-operative urine culture was obtained in the morning before the operation, fragmented stone collected were cultured in Departement of Microbiology. Patients were monitored closely in the postoperative period for signs of systemic inflammatory response syndrome (SIRS). Results:A total of 33 patients underwent PCNL and examined for urine cultures, stone culture and postoperative SIRS, 15 (45.45%) patients with positive urine culture, 18 patients (54.54%) with positive stone culture but only 1 patient (3.03%) had same pathogen (p = 0.629). Ten patients (55.6%) with positive stone cultures had evidence of systemic inflammatory respose syndrome postoperatively. The calculated stone culture value for sensitivity, specificity, positive predictive value and negative predictive value were 100%, 65.2%, 55.6%, and 100%. Preoperative hydronephrosis (p = 0.003) and operative time (p = 0.001) are identified as the key risk factors for SIRS after PCNL.Conclusion: Positive stone culture are better predictors for SIRS after PCNL. Stone culture examination is an essential in directing the proper antibiotic therapyin patients with SIRS after PCNL.  Keywords: Percutaneous nephrolithotomy (PCNL), urine culture, stone culture, systemic inflammatory response syndrome after PCNL.


2000 ◽  
Vol 9 (3-4) ◽  
pp. 193-195 ◽  
Author(s):  
Donato Torre ◽  
Roberto Tambini ◽  
Silvana Aristodemo ◽  
Giovanna Gavazzeni ◽  
Antonio Goglio ◽  
...  

The systemic inflammatory response syndrome (SIRS) is an inflammatory process seen in association with a large number of clinical infective and noninfective conditions.The aim of this study was to investigate the role of anti-inflammatory cytokines such as interleukin–4 (IL–4), interleukin–10 (IL–10), and transforming growth factor-beta (TGF-beta). Serum levels of IL–4, IL–10 and TGF-β were determined in 45 patients with SIRS: 38 patients had SIRS of infectious origin, whereas seven patients had non-infectious SIRS. Twenty healthy subjects were used as controls.Serum levels of IL–4, IL–10 and TGFg were determined by an immunoenzyme assay. A significant increase of IL–4 was observed in these patients at the time of diagnosis and 5 days later. In contrast, serum levels of IL–10 were not increased at the time of diagnosis, but a slight decrease was noted after 5 days. Serum levels of TGF-β were not increased at time of diagnosis, and a slight increase was observed after 5 days. Serum levels of IL–4 were significantly higher in patients with infectious SIRS at the time of diagnosis, whereas no significant difference between infectious and non-infectious SIRS was noted for serum levels of IL–10 and TGF-β at the time of diagnosis and 5 days later.During SIRS, serum levels of IL–4 were significantly increased with a significant correlation between IL–4 and mortality, and only levels of IL–4 were significantly increased in the SIRS caused by infectious stimuli.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Yu Chen ◽  
Jianan Ren ◽  
Xiaodong Qin ◽  
Guanwei Li ◽  
Bo Zhou ◽  
...  

Background. The systemic inflammatory response syndrome (SIRS) is characterized by a hypercatabolic state induced by inflammatory mediators. Continuous venovenous hemofiltration (CVVH) stabilizes the internal environment but also aggravates loss of amino acids. The effect of CVVH on protein dynamics is largely unknown. We adopted the stable isotopic tracer technology to investigate how CVVH changed serum albumin metabolism.Methods. Twenty SIRS patients were randomized into low- (2000 mL/h) and high- (4000 mL/h) volume CVVH groups according to the rate of replacement fluid. Eight patients with abdominal infection matched for age, sex, and laboratory index served as controls. Consecutive arterial blood samples were drawn during a primed-constant infusion of two stable isotopes to determine the albumin fractional synthesis rate (FSR) and fractional breakdown rate (FBR).Results. Before treatment, there was no significant difference of FSR and FBR among 3 groups. After CVVH, the albumin FSR in high- and low-volume groups was 7.75 ± 1.08% and 7.30 ± 0.89%, respectively, both higher than in the control (5.83 ± 0.94%). There was no significant difference in albumin FBR after treatment.Conclusions. Protein dynamic indicators could reflect protein synthesis and breakdown state directly and effectively. CVVH increased albumin synthesis, while the breakdown rate remained at a high level independently of the CVVH rate.


2020 ◽  
Vol 3 (1) ◽  
pp. 75-79
Author(s):  
V. Vijay Kumar Reddy ◽  
Vijaya Bhaskar Reddy.G

Background: Urosepsis means a severe infection of urinary tract (UTI) and/or male genital tract (prostate) with features consistent with systemic inflammatory response syndrome. UTI may occur among all the age groups and produce a broad range of clinical syndromes ranging from asymptomatic bacteriuria to acute pyelonephritis with gram negative sepsis to septic shock. It is estimated that the mortality rate due to urosepsis ranges from 30 to 40 p.c respectively. Urosepsis may also cause multiple organ dysfunction, hypoperfusion or hypotension. Urosepsis due to percutaneous nephrolithotomy may be catastrophic despite prophylactic antibiotic coverage and negative midstream urine culture and sensitivity testing (C&S) and bacteria in the stone can be responsible for systemic infection. The aim of the study is to compare bladder urine (culture      & sensitivity) and collecting system urine and stone (culture and sensitivity) in predicting urosepsis following percutaneous nephrolithotomy. Subjects and Methods: A hospital-based, analytical prospective clinical study was conducted among thirty cases who were present during   the study period and had undergone percutaneous nephrolithotomy (PCNL). Cases were included irrespective of gender with renal calculi       in whom percutaneous nephrolithotomy was about to be done at Narayana Medical College & Hospital, Chintareddypalem, Nellore, Andhra Pradesh during 1st February 2014 to 31st January 2015. Data collected was divided into three main groups Midstream urine (C&S); Pelvic urine (C&S); and Stone (C&S) respectively. Data obtained was entered in Microsoft Excel-2013 and analyzed in SPSS version-22 trial. Appropriate statistical tests were applied and p-value less than 0.05 was considered as significant. Results: Bladder urine (C&S) was positive in 3/30 (10.00%) patients, Pelvic urine (C&S) in 5/30 (16.66 %) patients and Stone (C&S) in 8/30 (26.66 %) patients. Most of the infected specimens grew Escherichia coli followed by pseudomonas, klebsiella, enterococcus. Systemic Inflammatory Response Syndrome (SIRS) was reported among 26.7 p.c (8) of the patients. In one patient (3.33%) septic shock developed but no deaths were reported. Conclusion: Stone (C&S) and Pelvic urine (C&S) are better predictors of urosepsis than Bladder urine (C&S).


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