Early Detection of Bacteremia and Bacteriuria after Extracorporeal Shock Wave Lithotripsy By C-Reactive Protein Measurements


ABSTRACT :BACKGROUND:Extracorporeal shock wave lithotripsy (ESWL) has long been accepted as the least invasive and reliable method in the treatment of urolithiasis. The success rates have been very high in renal and upper ureteral stones . OBJECTIVE:Is early detection of bacteriuria and bacteriemia after extracorporeal shock wave lithotripsy (ESWL) of calcium and infection stones by measurement of plasma C-reactive protein (CRP) levels.METHODS: A total of 150 patients who had infection stones (n 54) and calcium stones (n 96) were included in the study. All patients had sterile urine before ESWL. The mean age was 41.6+_ 4.85 and male/female ratio was 2.12. Blood cultures were obtained within 1 hour post-ESWL period. Urine cultures were obtained 3 times just after and on the first and seventh day of ESWL. RESULTS: Post-ESWL evaluations showed 6 positive blood cultures with 4(5.32%) patients in infection stone and 2 (2.66%) patient in calcium stone groups, whereas urine cultures revealed 12 (16%) positive results in infection stones and 8(10..66%) in calcium stones. The patients who had positive cultures also had elevated plasma CRP levels when compared to the levels in patients with negative cultures (p 0.000). CONCLUSION: Bacteriuria and bacteriemia after ESWL have been well-identified entities and may be responsible from some of the post-ESWL complications. CRP can be useful for early detection of such complications.