Journal Article

Extensive characterizations of bacteria isolated from catheterized urine and stone matrices in patients with nephrolithiasis

Ratree Tavichakorntrakool, Vitoon Prasongwattana, Seksit Sungkeeree, Phitsamai Saisud, Pipat Sribenjalux, Chaowat Pimratana, Sombat Bovornpadungkitti, Pote Sriboonlue and Visith Thongboonkerd

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 11, pages 4125-4130
Published in print November 2012 | ISSN: 0931-0509
Published online March 2012 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfs057
Extensive characterizations of bacteria isolated from catheterized urine and stone matrices in patients with nephrolithiasis

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Background

Urinary tract infections are generally known to be associated with nephrolithiasis, particularly struvite stone, in which the most common microbe found is urea-splitting bacterium, i.e. Proteus mirabilis. However, our observation indicated that it might not be the case of stone formers in Thailand. We therefore extensively characterized microorganisms associated with all types of kidney stones.

Methods

A total of 100 kidney stone formers (59 males and 41 females) admitted for elective percutaneous nephrolithotomy were recruited and microorganisms isolated from catheterized urine and cortex and nidus of their stones were analyzed.

Results

From 100 stone formers recruited, 36 cases had a total of 45 bacterial isolates cultivated from their catheterized urine and/or stone matrices. Among these 36 cases, chemical analysis by Fourier-transformed infrared spectroscopy revealed that 8 had the previously classified ‘infection-induced stones’, whereas the other 28 cases had the previously classified ‘metabolic stones’. Calcium oxalate (in either pure or mixed form) was the most common and found in 64 and 75% of the stone formers with and without bacterial isolates, respectively. Escherichia coli was the most common bacterium (approximately one-third of all bacterial isolates) found in urine and stone matrices (both nidus and periphery). Linear regression analysis showed significant correlation (r = 0.860, P < 0.001) between bacterial types in urine and stone matrices. Multidrug resistance was frequently found in these isolated bacteria. Moreover, urea test revealed that only 31% were urea-splitting bacteria, whereas the majority (69%) had negative urea test.

Conclusions

Our data indicate that microorganisms are associated with almost all chemical types of kidney stones and urea-splitting bacteria are not the major causative microorganisms found in urine and stone matrices of the stone formers in Thailand. These data may lead to rethinking and a new roadmap for future research regarding the role of microorganisms in kidney stone formation.

Keywords: antibiotic susceptibility; prevalence; stone matrix; urine; uropathogenic bacteria

Journal Article.  3256 words.  Illustrated.

Subjects: Nephrology

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