Objective

To compare the utility of preoperative urine culture with intraoperative stone culture findings, in predicting and treating post–PCNL systemic inflammatory response syndrome.

Methods

A prospective study of 60 patients treated with PCNL between August 2017 and December 2017 who had both pre–operative urine cultures and intraoperative stone cultures were included. Statistical analysis was done using chi–square and Fischer exact test.

Results

 A total of 60 patients were included in our study. The Mid–stream culture & Sensitivity was positive in 10% and stone Culture and Sensitivity in 35% of the patients. Eighteen patients had systemic inflammatory response syndrome (SIRS) and only one patient had septic shock. Out of the 18 with SIRS, 16 cases were stone C and S positive and  only one patients had positive mid–stream culture and sensitivity

Conclusion

Stone culture and sensitivity is a better predictor of potential urosepsis than mid–stream culture. Stone culture may be the best guide for antibiotic therapy in case of sepsis. Obtaining an intra–operative stone culture is an easy, inexpensive, and valuable practice that should be a routine part of any PCNL surgery