The Importance of Urine Culture Investigation in Patients with Large Renal Stones: A Single Clinical Study

ORIGINAL ARTICLE
Flatra Fetahi, D. Çuni, I. Miftari, Xh. Çuni, S. Mehmeti, A. Neziri, A. Elshani, L. Selmani, B. Gllareva, L. Çuni, D. Hoxha, E. Çuni

 
For citation: Fetahi F, Çuni D, Miftari I, Çuni Xh, Mehmeti S, Neziri A, Elshani A, Selmani L, Gllareva B, Çuni L, Hoxha D, Çuni E. The Importance of Urine Culture Investigation in Patients with Large Renal Stones: A Single Clinical Study. International Journal of Biomedicine. 2025;15(1):146-149. doi:10.21103/Article15(1)_OA15
 
Originally published March 5, 2025

Abstract: 

Background: The increased prevalence of kidney stone disease is considered a global health pandemic. Seeing that in many studies, there are differences in the presentation of this problem depending on the geographical distribution of the countries and on the age and gender of the patients, we have tried to present some study data carried out in Kosovo. We aimed to verify the presence of the urinary bacteriological agent through examining urine culture in 127 selected patients with large renal stones (>4.5 cm) in the Clinic of Urology (Prishtina, Kosovo) in a cohort study from September 2000 to September 2025.
Methods and Results: All patients completed the necessary lab test and CT KUB. Bacteriological culture of urine before surgery and analysis of stone composition after surgery were analyzed individually for each patient.
According to the appearance of the stone, patients were divided into two main groups: Group 1 included 114 patients (70 women and 44 men) with branched stones, and Group 2 included 13 patients (7 men and 6 women) with unbranched stones. In Group 1, 60.5% of cases were confirmed positive culture. The positive cultures dominated in women (69.6%). Proteus was the most frequent (21.1%), followed by Pseudomonas (12.3%), Enterococcus (9.6%), Klebsiella (7.9%), Staphylococcus aureus (5.3%), and E. coli (4.4%).  Regarding the chemical analysis of participants in this group, the most common type was the struvite stones (57.0%), followed by a mixed type composed of calcium oxalate (CaOx) and calcium phosphate (CaPO4) in 3.5% of cases.
In Group 2, the positive culture was identified in 46.2% of cases, and sterile culture was in 53.8% of cases, and there was no significant difference between Groups 1 and 2.  E. coli was the most frequent (30.8%), followed by Klebsiella (15.4%). According to the type of bacteria isolated, there was a significant difference between groups (P=0.003). Regarding the chemical analysis, in Group 2, the most common type was the stones composed of calcium content (CaOx and CaPO4) in 11(84.6%) cases, followed by acid uric composition in two cases (15.4%). According to the composition of the stones, we obtained a significant difference between the groups (P=0.000).
Conclusion: In patients with branched stones, the main bacteria isolated is Proteus, and the chemical composition was struvite. In patients with unbranched stones, the dominant bacteria isolated is E. coli, and the dominant chemical composition is calcium.

Keywords: 
renal stone • urinary tract infection • urine culture
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Received December 14, 2024.
Accepted January 21, 2025.
©2025 International Medical Research and Development Corporation.