Prediction of Bacteriuria Based on Clinical or Laboratory Parameters in Patients with Indwelling Ureteral Stents Before Ureterorenoscopy Should Not Substitute for Urine Cultures

Journal of Endourology
Annina WeberDominik Abt

Abstract

Urine cultures before secondary ureterorenoscopy (URS) are recommended to exclude bacteriuria, but results are often pending on the day of surgery. We sought to develop predictive models that reliably indicate the absence of bacteriuria in patients with indwelling ureteral stents based on readily available data. Records of patients undergoing secondary URS between 2014 and 2017 were assessed retrospectively. Patient characteristics, automated urinary sediment analysis, blood analyses, and results of urine cultures were analyzed using descriptive statistics, receiver operating characteristic curves, logistic regression, and model selection. Of 462 patients, 101 (21.9%) had positive urine cultures. Urinary leucocytes, nitrite and pH, patient age and sex, and blood C-reactive protein (CRP) levels were associated with bacteriuria in logistic regression (p < 0.05), but did not sharply separate patients with and without bacteriuria. A multiple logistic regression model considering all six parameters and their interactions indicated a low probability of bacteriuria (8%) for 74% of the patients. Alternatively, recursive partitioning indicated low probability of bacteriuria (8%) if four criteria are simultaneously fulfilled (54% of the ...Continue Reading

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