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Upper urinary tract stones & Ureaplasma urealyticum
1Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Abstract:
Extensive culture of stones and of pre-operative and renal pelvic urine for isolation of bacteria and Ureaplasma urealyticum were performed in 70 patients of nephrolithiasis. Stones were subjected to biochemical analysis and scanning electron microscopy. Micro-organisms were isolated from 33 (47%) of 70 renal stones. Of the 38 species of micro-organisms isolated, 14 were urea-splitting (U. urealyticum 2; Klebsiella pneumoniae 8; Morganella morganii 1; Acinetobacter spp 3) and 24 were nonurea splitting. U. urealyticum was cultured from the renal stones of two patients. Pelvic urine, unlike voided urine did reflect the bacteriology of the stone. Biochemically, 55 stones (79%) were calcium oxalate phosphate stones, 10 (14%) were calcium oxalate stones and 5 (7%) were uric acid stones. None of the stones were found to be of struvite composition. These data suggest that infection stones are uncommon in this part of the country. Further, infection of renal stones with fastidious organisms like U. urealyticum and multi-drug resistant bacteria necessitate their removal to ensure complete cure.
Insights
Infection stones are uncommon in nephrolithiasis patients, with most stones being calcium oxalate phosphate. Removal of renal stones is crucial for treating fastidious organisms like Ureaplasma urealyticum.
Area of Science:
- Nephrology
- Microbiology
- Biochemistry
Background:
- Nephrolithiasis (kidney stones) can be associated with bacterial infections.
- Understanding the microbial composition of kidney stones is crucial for effective treatment.
Purpose of the Study:
- To investigate the prevalence of bacterial and Ureaplasma urealyticum infections in kidney stones.
- To analyze the biochemical composition of kidney stones and correlate it with microbial findings.
Main Methods:
- Culture of renal stones and pelvic urine from 70 nephrolithiasis patients.
- Biochemical analysis and scanning electron microscopy of stones.
- Isolation and identification of micro-organisms.
Main Results:
- Micro-organisms were isolated from 47% of renal stones.
- Urea-splitting bacteria, including Ureaplasma urealyticum, were identified.
- Pelvic urine accurately reflected stone bacteriology, unlike voided urine.
- Most stones were calcium oxalate phosphate (79%), with none of struvite composition.
- Infection stones were found to be uncommon.
Conclusions:
- Infection stones appear uncommon in this region.
- The presence of fastidious organisms like Ureaplasma urealyticum and multi-drug resistant bacteria in renal stones necessitates surgical removal for complete cure.