Molecular and biochemical detection of bacteria in adult patients with urinary tract infection associate renal stones

Abstract

Introduction: Introduction: Renal stone poses a significant public health issue worldwide, particularly in Iraq’s southern region. Although urinary tract infections are more likely in the presence of renal stones, the role of bacteria in the development of common stone types remains underexplored. Objectives: This study aimed to identify bacterial species isolated from urine and stones, to determine their sensitivity to antibiotics, and also to perform a chemical analysis of stones, focusing on the most prevalent type. Patients and Methods: One hundred adult patients with renal stones admitted to the surgical department of Al-Zahrawi surgical hospital in Maysan governorate were enrolled, then urine and surgical stone cultures were gathered. Bacterial identification was conducted using 16S rDNA gene sequencing. Additionally, a qualitative chemical composition analysis of stones was conducted. Results: A total of 130 bacterial isolates were identified (comprising nine different species), Escherichia coli was the predominant bacterium in both urine and stone cultures (41 and 20 isolates respectively), followed by Klebsiella pneumoniae (15 and 9, respectively) and Proteus mirabilis (11 and 8 respectively). Most isolates showed high sensitivity to imipenem and amikacin (80% and 71.5%, respectively; P<0.01), while sensitivity to tetracycline, sulfamethoxazole/trimethoprim, nitrofurantoin, and ampicillin was notably lower (30.7%, 24.9%, 21.5% and 12.3% respectively). The incidence of renal stones was more frequent in males (64%), particularly among patients aged 31-40 years (60%), with a significant difference at P ≤ 0.05. Additionally, calcium oxalate was the most common biochemical composition of stones (51%), followed by calcium phosphate and uric acid (19% and 15% respectively), since magnesium-ammonium phosphate, calcium carbonate, and cystine were less common (9%, 4%, and 2%, respectively). There was also a significant relationship between bacterial urinary tract infection and the presence of renal stones. Conclusion: The most common bacteria isolated from adult patients with renal stones in Maysan governorate were Escherichia coli, followed by Klebsiella pneumoniae and Proteus mirabilis. Calcium oxalate stones were most frequent, followed by uric acid. The infection rate between urinary tract infection and renal stones was 65% and this is considered significant.