Bacteriology of urinary tract stones.
It has been reported that up to half of renal stones and associated urine specimens have been positive on culture, and that up to 50% of such stones contain magnesium ammonium phosphate. In a prospective study using infrared and wet chemical analysis, we found positive cultures in only 7 of 132 renal, 5 of 105 ureteral and 6 of 21 bladder stones obtained surgically and handled with sterility. Of the culture positive calculi only 43% from the kidney, none from the ureter and 50% from the bladder contained detectable magnesium ammonium phosphate. However, magnesium ammonium phosphate was detectable in 20% of renal, 2% of ureteral and 27% of bladder stones with negative cultures. Of the culture positive renal and ureteral calculi 42% were predominantly calcium phosphate and 17% were predominantly calcium oxalate. For culture negative stones 25% and 51% from the kidney, and 15% and 82% from the ureter were composed of predominantly calcium phosphate and calcium oxalate, respectively. Among the culture positive stones, related positive urine cultures were noted in 100% of the renal, 20% of the ureteral and 50% of the bladder cases, compared to 26%, 10% and 27%, respectively, of culture negative calculi. The same organism was found in the stone and urine in only 38% of the cases. The lower frequency of positive urine cultures, of stones with magnesium ammonium phosphate, and especially of culture positive renal and ureteral stones (5%) than in previous reports suggests that stone culture may be of less value than indicated previously, except for bladder calculi and large renal stones, such as the branched type.
Gault
M H
MH
Memorial University, St. John's, Newfoundland, Canada.
Longerich
L L
LL
Crane
G
G
Cooper
R
R
Dow
D
D
Best
L
L
Stockall
E
E
Brown
W
W
D000328:Adult; D000368:Aged; D001419:Bacteria / Q000302:isolation & purification*; D002129:Calcium Oxalate / Q000032:analysis; D002130:Calcium Phosphates / Q000032:analysis; D005260:Female; D006801:Humans; D017616:Magnesium Compounds / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000032:analysis; D011446:Prospective Studies; D000069877:Struvite; D014545:Urinary Calculi / Q000737:chemistry / Q000382:microbiology*
D002130:Calcium Phosphates; D017616:Magnesium Compounds; D010710:Phosphates; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; D002129:Calcium Oxalate; C485838:calcium phosphate, monobasic, anhydrous; C020243:calcium phosphate; D000069877:Struvite; C485829:calcium phosphate, dibasic, anhydrous