title: [Urinary tract infections and Urolithiasis].
abstract: The classic "infection stone" struvite is formed as a result of metabolic activity of urease-positive bacteria from alkaline urine with pH-values above 7.5. Due to improved infection diagnostics and antibiotic therapy, the occurrence of infection-related urinary stones in the western industrialized world decreases, despite the generally increasing prevalence rates of urolithiasis in these societies. Struvite is often associated with other mineral phases. These accessory mineral phases could indicate other, non-infection-related causes of urinary stone formation. Thus, mineral analysis is always recommended. Struvite stones as well as struvite encrustations on urinary tract implants are characterized by rapid growth. The rapid growth-related embedding of urease-positive bacteria in the crystalline material makes the urinary stone a persistent source of recurrent urinary tract infections. According to the German Society of Urology guidelines on urolithiasis, a patient with the diagnosis "infection stone" should be assigned to the "high-risk" patient group. Complete stone and debris removal, as well as a special metaphylaxis strategy are required to initiate successful stone therapy.
authors.affiliation: Academic Medical Center, Department of Urology, University of Amsterdam, Meibergdreef 9, NL-1105, AZ Amsterdam, Niederlande. a.meissner@amc.uva.nl
authors.forename: A
authors.initials: A
authors.lastname: Meissner
authors.forename: C
authors.initials: C
authors.lastname: Mamoulakis
authors.forename: N
authors.initials: N
authors.lastname: Laube
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D004352:Drug Resistance, Microbial; D006801:Humans; D017616:Magnesium Compounds / Q000652:urine; D010710:Phosphates / Q000652:urine; D012008:Recurrence; D012307:Risk Factors; D000069877:Struvite; D014510:Urease / Q000502:physiology; D014545:Urinary Calculi / Q000737:chemistry / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D017616:Magnesium Compounds; D010710:Phosphates; D000069877:Struvite; D014510:Urease
references.citation: Urol Res. 2006 Apr;34(2):146-50
references.pmid: 16477427
references.citation: J Urol. 1962 Oct;88:545-62
references.pmid: 13954078
references.citation: Int J Antimicrob Agents. 2002 Jun;19(6):488-98
references.pmid: 12135839
references.citation: Nephron. 1999;81 Suppl 1:50-9
references.pmid: 9873215
references.citation: Curr Opin Urol. 2009 Mar;19(2):205-10
references.pmid: 19188775
references.citation: J Biomed Mater Res B Appl Biomater. 2008 Nov;87(2):590-7
references.pmid: 18506826
references.citation: Crit Rev Microbiol. 1988;16(1):37-79
references.pmid: 3053050
references.citation: Scand J Urol Nephrol. 1990;24(3):205-10
references.pmid: 2237297
references.citation: Urologe A. 2003 Jan;42(1):47-55
references.pmid: 12574884
references.citation: Urologe A. 2009 Sep;48(9):1084-93
references.pmid: 19585095
references.citation: Kidney Int. 1978 May;13(5):372-82
references.pmid: 351265
references.citation: Clin Microbiol Rev. 2008 Jan;21(1):26-59
references.pmid: 18202436
references.citation: Br J Urol. 1970 Oct;42(5):511-8
references.pmid: 4920223
references.citation: Cleve Clin J Med. 2009 Oct;76(10):583-91
references.pmid: 19797458
references.citation: Dtsch Med Wochenschr. 1972 Nov 3;97(44):1694-701
references.pmid: 4639328
references.citation: J Urol. 1978 Jan;119(1):9-15
references.pmid: 23442
references.citation: Br J Urol. 1984 Jun;56(3):244-9
references.pmid: 6544607
references.citation: Drugs Aging. 2005;22(8):627-39
references.pmid: 16060714
references.citation: J Clin Invest. 2003 Nov;112(10):1466-77
references.pmid: 14617746
references.citation: Urologe A. 1992 Mar;31(2):98-102
references.pmid: 1561736