Antibiotic resistance in patients with coral kidney stones: results of a clinical and microbiological study.
DOI:
https://doi.org/10.63682/jns.v15i1s.10463Keywords:
Coral nephrolithiasis; urolithiasis; antibiotic resistance; urinary tract infections; bacteriological culture; antibiotic sensitivity; uropathogens; Escherichia coli; Proteus mirabilis; percutaneous nephrolithotomyAbstract
Coral nephrolithiasis is one of the most severe forms of urolithiasis, closely related to chronic urinary tract infection. The growth of antibiotic resistance of uropathogenic microorganisms significantly complicates the choice of effective antibacterial therapy and increases the risk of postoperative infectious complications. To study the spectrum of microorganisms and the features of their antibiotic resistance in patients with coralloid kidney stones, as well as to evaluate the sensitivity of isolated pathogens to the most commonly used antibacterial drugs. A single-center retrospective clinical and microbiological study (example) was conducted with 124 patients with coralloid kidney stones. All patients underwent bacteriological examination of urine to determine the sensitivity of microorganisms to antibacterial drugs. In some patients, urine from the renal pelvis and fragments of removed concretions were additionally examined. The antibiotic sensitivity analysis was performed in accordance with the recommendations of EUCAST. Positive bacteriological culture of urine was obtained in 71.8% of patients. The most frequently isolated were Escherichia coli (34.8%), Proteus mirabilis (20.2%), Klebsiella pneumoniae (15.7%) and Pseudomonas aeruginosa (11.2%). The highest sensitivity of microorganisms was observed to carbapenems and amikacin, while a high level of resistance was detected to fluoroquinolones and aminopenicillins. Multidrug-resistant strains were found in 32.6% of patients. The results obtained indicate a high prevalence of antibiotic resistance among pathogens of urinary tract infections in patients with coralloid nephrolithiasis. The study demonstrates the need for mandatory microbiological examination to determine antibiotic sensitivity in patients with coralloid kidney stones. The use of local data on antibiotic resistance makes it possible to optimize the choice of empirical antibacterial therapy, reduce the incidence of infectious complications, and improve the effectiveness of surgical treatment...
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