KIỂM SOÁT NHIỄM KHUẨN NIỆU TRƯỚC TÁN SỎI THẬN QUA DA: ĐẶC ĐIỂM VI KHUẨN HỌC VÀ KẾT QUẢ ĐIỀU TRỊ

Abstract

Objectives: To describe the microbiological characteristics and infection-control outcomes of preoperative urinary tract infections in patients with kidney stones undergoing percutaneous nephrolithotomy (PCNL). Methods: A prospective, descriptive study was conducted on 41 patients with kidney stones complicated by lower urinary tract infection who underwent infection control before mini-PCNL at 108 Military Central Hospital from October 2024 to March 2025. Evaluated variables included microbiological cultures, systemic inflammatory response syndrome (SIRS), drainage methods, antibiotic treatment, and early postoperative infectious complications. Results: Lower urinary tract culture was positive in 33/41 patients (80.5%). Among 41 urinary isolates, Gram-negative bacteria predominated (78.0%); Escherichia coli (E. coli) accounted for 48.8% and Pseudomonas aeruginosa (P. aeruginosa) accounted for 14.6%. SIRS was recorded in 18/41 patients (43.9%). Percutaneous nephrostomy was performed in 20/41 patients (48.8%). Among 21 patients initially treated with empirical antibiotics, 13 regimens were concordant with antimicrobial susceptibility testing (61.9%). The mean duration of antibiotic therapy was 8.98 ± 4.01 days. Postoperative fever occurred in 3/41 patients (7.3%); no postoperative sepsis or septic shock was recorded. Conclusion: Preoperative urinary tract infection before PCNL was mainly caused by Gram-negative bacteria. Antibiotic therapy combined with decompressive drainage when indicated controlled infection before surgery and contributed to a low rate of early postoperative infectious complications.