Research Article
BibTex RIS Cite

Endoskopik üriner sistem taş tedavisi sonrası ürosepsis: riski artıran faktörler

Year 2021, Volume: 13 Issue: 1, 10 - 16, 31.01.2021

Abstract

Amaç: Üriner sistem taşları sıklığı giderek artan, sağlık sistemi üzerine ciddi mali yük oluşturan bir hastalıktır. Ürolitiyazisin endoskopik tedavisi sonrasında üriner enfeksiyonlar azımsanmayacak düzeydedir. Bu çalışmada endoskopik taş tedavisi alan hastalarda ürosepsis görülme insidansı ve bunu arttıran faktörleri inceledik. Böylece hastalarda ürosepsisi engellemeye yönelik alınacak tedbirlerle ilgili tartışamaya katkı sağlamayı amaçladık.


Gereç ve Yöntemler:
Böbrek veya üreter taşı nedeni ile endoskopik taş tedavisi yapılan hastalar çalışmaya dahil edildi. Sepsis geçiren ve geçirmeyen olarak ayrılan iki grup birbiri ile yaş, cinsiyet, komorbidite, rezidü taş açısından birbiri ile kıyaslandı.

Bulgular: Çalışmaya dahil edilen toplam hasta sayısı 561’di. Çalışmaya dahil edilen hastaların median yaşı 39 (18-77)’ti. 18-40, 41-60 ve 61-80 yaş aralıklarına göre gruplanan hastalarda sırasıyla 12 (%4.2), 31 (%14.2) ve 9 (%16.7) hastada sepsis bulguları görüldü. Bu gruplar arasında sepsis görülme oranları açısından anlamlı fark vardı (p<0,001). Komorbiditesi olan hasta grubunda 39 (%25.3) hastada sepsis görülürken, komorbiditesi olmayan hasta grubunda 13 (%3.2) hastada sepsis görüldü. İki grup arasında sepsis görülme oranları açısından istatistiksel olarak anlamlı fark bulundu (p<0,001).

Sonuç: Postoperatif ürosepsisi kolaylaştırıcı etmenlerin bilinmesi, etkili proflaksi ve tedavide etkin antibiyoterapi açısından önemlidir. Yüksek hasta sayıları ile elde edilecek bulgular ürosepsisin yarattığı maliyet ve morbidite oranlarını düşürebilir.

References

  • 1. Miller, N.L. & Lingeman, J.E. Management of kidney stones. Bmj 334, 468-472 (2007).
  • 2. Pearle, M.S., Calhoun, E.A., Curhan, G.C. & Project, U.D.o.A. Urologic diseases in America project: urolithiasis. The Journal of urology 173, 848-857 (2005).
  • 3. De La Rosette, J., et al. The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients. Journal of Endourology 28, 131-139 (2014).
  • 4. Romero, V., Akpinar, H. & Assimos, D.G. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Reviews in urology 12, e86 (2010).
  • 5. Soucie, J.M., Thun, M.J., Coates, R.J., McClellan, W. & Austin, H. Demographic and geographic variability of kidney stones in the United States. Kidney international 46, 893-899 (1994).
  • 6. Sánchez-Martín, F. & Martínez-Rodríguez, R. Incidence and prevalence of published studies about urolithiasis in Spain. A review. Actas Urológicas Españolas 31, 511-520 (2007).
  • 7. Wright, A.E., Rukin, N.J. & Somani, B.K. Ureteroscopy and stones: Current status and future expectations. World journal of nephrology 3, 243 (2014).
  • 8. Giusti, G., et al. Sky is no limit for ureteroscopy: extending the indications and special circumstances. World journal of urology 33, 257-273 (2015).
  • 9. Fall, B., Mouracade, P., Bergerat, S. & Saussine, C. Flexible ureteroscopy and laser lithotripsy for kidney and ureter stone: indications, morbidity and outcome. Progres en urologie: journal de l'Association francaise d'urologie et de la Societe francaise d'urologie 24, 771 (2014).
  • 10. Cindolo, L., et al. Mortality and flexible ureteroscopy: analysis of six cases. World journal of urology 34, 305-310 (2016).
  • 11. Turk, C., et al. European Association of Urology Guidelines on Urolithiasis, 2012. Available via www. uroweb. org/gls/pdf/20_Urolithiasis_LR% 20March 202012(2013).
  • 12. Somani, B., et al. Complications associated with ureterorenoscopy (URS) related to treatment of urolithiasis: the Clinical Research Office of Endourological Society URS Global study. World journal of urology 35, 675-681 (2017).
  • 13. Berardinelli, F., et al. A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone. International braz j urol 42, 479-486 (2016).
  • 14. Baş, O., et al. Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures—a single-center experience. World journal of urology 35, 819-826 (2017).
  • 15. Mossanen, M., et al. Overuse of antimicrobial prophylaxis in community practice urology. The Journal of urology 193, 543-547 (2015).
  • 16. Kalra, O. & Raizada, A. Management issues in urinary tract infections. J Gen Med 18, 16-22 (2006).
  • 17. Rs, H. & Karl, I. The pathophysiology and treatment of sepsis. N Engl J Med 348, 138-150 (2003).
  • 18. Johansen, T.E.B., et al. Prevalence of hospital-acquired urinary tract infections in urology departments. European urology 51, 1100-1112 (2007).
  • 19. Gastmeier, P., et al. Prevalence of nosocomial infections in representative German hospitals. Journal of Hospital infection 38, 37-49 (1998).
  • 20. Rosser, C.J., Bare, R.L. & Meredith, J.W. Urinary tract infections in the critically ill patient with a urinary catheter. The American journal of surgery 177, 287-290 (1999).
  • 21. Dellinger, R.P., et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive care medicine 39, 165-228 (2013).
  • 22. Bonkat, G., et al. Urological infections. Arnhem: European Association of Urology (2018).
  • 23. Martin, G.S., Mannino, D.M., Eaton, S. & Moss, M. The epidemiology of sepsis in the United States from 1979 through 2000. New England Journal of Medicine 348, 1546-1554 (2003).
  • 24. Mitsuzuka, K., Nakano, O., Takahashi, N. & Satoh, M. Identification of factors associated with postoperative febrile urinary tract infection after ureteroscopy for urinary stones. Urolithiasis 44, 257-262 (2016).
  • 25. Pérez, D.D., et al. Urinary sepsis after endourological ureterorenoscopy for the treatment of lithiasis. Actas Urológicas Españolas (English Edition) 43, 293-299 (2019).
  • 26. Guglietta, A. Recurrent urinary tract infections in women: risk factors, etiology, pathogenesis and prophylaxis. Future Microbiology 12, 239-246 (2017).
  • 27. Raje, N. & Dinakar, C. Overview of immunodeficiency disorders. Immunology and Allergy Clinics 35, 599-623 (2015).
  • 28. Daudon, M., Dore, J.-C., Jungers, P. & Lacour, B. Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urological research 32, 241-247 (2004).
  • 29. Nevo, A., Mano, R., Baniel, J. & Lifshitz, D.A. Ureteric stent dwelling time: a risk factor for post‐ureteroscopy sepsis. Bju International 120, 117-122 (2017).
  • 30. DeGroot-Kosolcharoen, J., Guse, R. & Jones, J.M. Evaluation of a urinary catheter with a preconnected closed drainage bag. Infection Control & Hospital Epidemiology 9, 72-76 (1988).
  • 31. Scotland, K.B. & Lange, D. Prevention and management of urosepsis triggered by ureteroscopy. Research and reports in urology 10, 43 (2018).
  • 32. Paick, S.H., Park, H.K., Oh, S.-J. & Kim, H.H. Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 62, 214-217 (2003).
  • 33. Miano, R., Germani, S. & Vespasiani, G. Stones and urinary tract infections. Urologia internationalis 79, 32-36 (2007).
  • 34. Cek, M., et al. Healthcare-associated urinary tract infections in hospitalized urological patients—a global perspective: results from the GPIU studies 2003–2010. World journal of urology 32, 1587-1594 (2014).
  • 35. Salam, M. Rational Use of Antibiotics and Antibiotics Prophylaxis in Urological Practice. Bangladesh Journal of Urology 22, 85-94 (2019).
  • 36. Delamaire, M., et al. Impaired leucocyte functions in diabetic patients. Diabetic Medicine 14, 29-34 (1997).
  • 37. Geerlings, S.E., et al. Asymptomatic bacteriuria can be considered a diabetic complication in women with diabetes mellitus. in Genes and Proteins Underlying Microbial Urinary Tract Virulence 309-314 (Springer, 2002).
  • 38. Truzzi, J.C.I., Almeida, F.M.R., Nunes, E.C. & Sadi, M.V. Residual urinary volume and urinary tract infection—when are they linked? The Journal of urology 180, 182-185 (2008).
  • 39. Daels, F.P.J., et al. Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World journal of urology 33, 859-864 (2015).
  • 40. Tandoğdu, Z., et al. Antimicrobial resistance in urosepsis: outcomes from the multinational, multicenter global prevalence of infections in urology (GPIU) study 2003–2013. World journal of urology 34, 1193-1200 (2016).
  • 41. Bouza, E., et al. A European perspective on nosocomial urinary tract infections II. Report on incidence, clinical characteristics and outcome (ESGINI–04 study). Clinical Microbiology and Infection 7, 532-542 (2001).

Urosepsis after endoscopic urinary system stone treatment: factors increasing risk

Year 2021, Volume: 13 Issue: 1, 10 - 16, 31.01.2021

Abstract

Objective: Urinary system stones are an increasingly common disease that creates serious financial burden on the health system. Urinary infections are substantial after endoscopic treatment of urolithiasis. In this study, we examined the incidence of urosepsis in patients applied endoscopic stone treatment and the factors that increase it. Thus, we aimed to contribute to the discussion on measures to be taken to prevent urosepsis in patients.

Material and Methods: Patients who underwent endoscopic stone treatment for kidney or ureteral stones were included in the study. The two groups, which were divided into those with and without sepsis, were compared with each other in terms of age, gender, comorbidity, and residual stones.

Results: The total number of patients included in the study was 561. The median age of the patients included in the study was 39 (18-77). Sepsis findings were observed in 12 (4.2%), 31 (14.2%) and 9 (16.7%) patients, respectively, in patients grouped according to the age range of 18-40, 41-60 and 61-80 years. There was a significant difference between these groups in terms of the incidence of sepsis (p <0.001). While 39 (25.3%) patients had sepsis in the patient group with comorbidity, 13 (3.2%) patients had sepsis in the patient group without comorbidity. A statistically significant difference was found between the two groups in terms of the rates of sepsis (p <0.001).

Conclusion: Recognizing the factors that facilitate postoperative urosepsis is important for effective prophylaxis and effective antibiotherapy in treatment. Findings to be obtained with high patient numbers may decrease the cost and morbidity rates created by urosepsis.

References

  • 1. Miller, N.L. & Lingeman, J.E. Management of kidney stones. Bmj 334, 468-472 (2007).
  • 2. Pearle, M.S., Calhoun, E.A., Curhan, G.C. & Project, U.D.o.A. Urologic diseases in America project: urolithiasis. The Journal of urology 173, 848-857 (2005).
  • 3. De La Rosette, J., et al. The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients. Journal of Endourology 28, 131-139 (2014).
  • 4. Romero, V., Akpinar, H. & Assimos, D.G. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Reviews in urology 12, e86 (2010).
  • 5. Soucie, J.M., Thun, M.J., Coates, R.J., McClellan, W. & Austin, H. Demographic and geographic variability of kidney stones in the United States. Kidney international 46, 893-899 (1994).
  • 6. Sánchez-Martín, F. & Martínez-Rodríguez, R. Incidence and prevalence of published studies about urolithiasis in Spain. A review. Actas Urológicas Españolas 31, 511-520 (2007).
  • 7. Wright, A.E., Rukin, N.J. & Somani, B.K. Ureteroscopy and stones: Current status and future expectations. World journal of nephrology 3, 243 (2014).
  • 8. Giusti, G., et al. Sky is no limit for ureteroscopy: extending the indications and special circumstances. World journal of urology 33, 257-273 (2015).
  • 9. Fall, B., Mouracade, P., Bergerat, S. & Saussine, C. Flexible ureteroscopy and laser lithotripsy for kidney and ureter stone: indications, morbidity and outcome. Progres en urologie: journal de l'Association francaise d'urologie et de la Societe francaise d'urologie 24, 771 (2014).
  • 10. Cindolo, L., et al. Mortality and flexible ureteroscopy: analysis of six cases. World journal of urology 34, 305-310 (2016).
  • 11. Turk, C., et al. European Association of Urology Guidelines on Urolithiasis, 2012. Available via www. uroweb. org/gls/pdf/20_Urolithiasis_LR% 20March 202012(2013).
  • 12. Somani, B., et al. Complications associated with ureterorenoscopy (URS) related to treatment of urolithiasis: the Clinical Research Office of Endourological Society URS Global study. World journal of urology 35, 675-681 (2017).
  • 13. Berardinelli, F., et al. A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone. International braz j urol 42, 479-486 (2016).
  • 14. Baş, O., et al. Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures—a single-center experience. World journal of urology 35, 819-826 (2017).
  • 15. Mossanen, M., et al. Overuse of antimicrobial prophylaxis in community practice urology. The Journal of urology 193, 543-547 (2015).
  • 16. Kalra, O. & Raizada, A. Management issues in urinary tract infections. J Gen Med 18, 16-22 (2006).
  • 17. Rs, H. & Karl, I. The pathophysiology and treatment of sepsis. N Engl J Med 348, 138-150 (2003).
  • 18. Johansen, T.E.B., et al. Prevalence of hospital-acquired urinary tract infections in urology departments. European urology 51, 1100-1112 (2007).
  • 19. Gastmeier, P., et al. Prevalence of nosocomial infections in representative German hospitals. Journal of Hospital infection 38, 37-49 (1998).
  • 20. Rosser, C.J., Bare, R.L. & Meredith, J.W. Urinary tract infections in the critically ill patient with a urinary catheter. The American journal of surgery 177, 287-290 (1999).
  • 21. Dellinger, R.P., et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive care medicine 39, 165-228 (2013).
  • 22. Bonkat, G., et al. Urological infections. Arnhem: European Association of Urology (2018).
  • 23. Martin, G.S., Mannino, D.M., Eaton, S. & Moss, M. The epidemiology of sepsis in the United States from 1979 through 2000. New England Journal of Medicine 348, 1546-1554 (2003).
  • 24. Mitsuzuka, K., Nakano, O., Takahashi, N. & Satoh, M. Identification of factors associated with postoperative febrile urinary tract infection after ureteroscopy for urinary stones. Urolithiasis 44, 257-262 (2016).
  • 25. Pérez, D.D., et al. Urinary sepsis after endourological ureterorenoscopy for the treatment of lithiasis. Actas Urológicas Españolas (English Edition) 43, 293-299 (2019).
  • 26. Guglietta, A. Recurrent urinary tract infections in women: risk factors, etiology, pathogenesis and prophylaxis. Future Microbiology 12, 239-246 (2017).
  • 27. Raje, N. & Dinakar, C. Overview of immunodeficiency disorders. Immunology and Allergy Clinics 35, 599-623 (2015).
  • 28. Daudon, M., Dore, J.-C., Jungers, P. & Lacour, B. Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urological research 32, 241-247 (2004).
  • 29. Nevo, A., Mano, R., Baniel, J. & Lifshitz, D.A. Ureteric stent dwelling time: a risk factor for post‐ureteroscopy sepsis. Bju International 120, 117-122 (2017).
  • 30. DeGroot-Kosolcharoen, J., Guse, R. & Jones, J.M. Evaluation of a urinary catheter with a preconnected closed drainage bag. Infection Control & Hospital Epidemiology 9, 72-76 (1988).
  • 31. Scotland, K.B. & Lange, D. Prevention and management of urosepsis triggered by ureteroscopy. Research and reports in urology 10, 43 (2018).
  • 32. Paick, S.H., Park, H.K., Oh, S.-J. & Kim, H.H. Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 62, 214-217 (2003).
  • 33. Miano, R., Germani, S. & Vespasiani, G. Stones and urinary tract infections. Urologia internationalis 79, 32-36 (2007).
  • 34. Cek, M., et al. Healthcare-associated urinary tract infections in hospitalized urological patients—a global perspective: results from the GPIU studies 2003–2010. World journal of urology 32, 1587-1594 (2014).
  • 35. Salam, M. Rational Use of Antibiotics and Antibiotics Prophylaxis in Urological Practice. Bangladesh Journal of Urology 22, 85-94 (2019).
  • 36. Delamaire, M., et al. Impaired leucocyte functions in diabetic patients. Diabetic Medicine 14, 29-34 (1997).
  • 37. Geerlings, S.E., et al. Asymptomatic bacteriuria can be considered a diabetic complication in women with diabetes mellitus. in Genes and Proteins Underlying Microbial Urinary Tract Virulence 309-314 (Springer, 2002).
  • 38. Truzzi, J.C.I., Almeida, F.M.R., Nunes, E.C. & Sadi, M.V. Residual urinary volume and urinary tract infection—when are they linked? The Journal of urology 180, 182-185 (2008).
  • 39. Daels, F.P.J., et al. Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World journal of urology 33, 859-864 (2015).
  • 40. Tandoğdu, Z., et al. Antimicrobial resistance in urosepsis: outcomes from the multinational, multicenter global prevalence of infections in urology (GPIU) study 2003–2013. World journal of urology 34, 1193-1200 (2016).
  • 41. Bouza, E., et al. A European perspective on nosocomial urinary tract infections II. Report on incidence, clinical characteristics and outcome (ESGINI–04 study). Clinical Microbiology and Infection 7, 532-542 (2001).
There are 41 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Research Articles
Authors

Dilek Bulut 0000-0001-5874-174X

Merve Sefa Sayar 0000-0002-0436-4122

Ender Cem Bulut 0000-0002-5002-5471

Alper Bitkin 0000-0003-4724-3053

Fatih Bıçaklıoğlu 0000-0001-7175-713X

Serhat Çetin This is me 0000-0001-5450-5168

Murat Koparal 0000-0002-8347-5727

Kasım Ertaş 0000-0003-4300-1399

Publication Date January 31, 2021
Published in Issue Year 2021 Volume: 13 Issue: 1

Cite

Vancouver Bulut D, Sayar MS, Bulut EC, Bitkin A, Bıçaklıoğlu F, Çetin S, Koparal M, Ertaş K. Urosepsis after endoscopic urinary system stone treatment: factors increasing risk. Endourol Bull. 2021;13(1):10-6.