Risk factors of urinary tract infection and predictive value of serum procalcitonin in patients with upper urinary tract calculi after operation

LIU Qing; MA Saihua; WU Leibin

doi:10.3969/j.issn.1002-3429.2025.24.015

Abstract：Objective To investigate the risk factors for urinary tract infection(UTI)in patients with upper urinary tract calculi(UUTC)after operation and the predictive value of serum procalcitonin(PCT)for UTI.Methods A total of 200 patients with UUTC admitted from January 2023 to February 2025 were selected as the research subjects.All patients received surgical treatment.Within 7 d after operation,they were divided into infection group and non-infection group according to the results of etiological culture.The clinical data of the two groups were statistically analyzed.Multivariate logistic regression was used to analyze the influencing factors of UTI in patients with UUTC after operation.The levels of serum PCT,tumor necrosis factor-α(TNF-α)and decoy receptor 3(DcR3)were compared between the two groups.The predictive value of serum PCT,TNF-α and DcR3 levels for UTI in patients after surgery for UUTC was analyzed.Results Among the 200 patients,52 had UTI,with an infection rate of 26.00％.Gram-negative bacteria accounted for a relatively high proportion,and Escherichia coli was the dominant strain,which was highly resistant to Norfloxacin and Ampicillin.The levels of serum PCT,TNF-α and DcR3 in the infection group were higher than those in the non-infection group(P＜0.05).Diabetes,stone diameter,urinary tract obstruction,hydronephrosis,type of preoperative antimicrobial agents used,duration of preoperative antimicrobial agent use,serum PCT,TNF-α and DcR3 levels were risk factors for UTI in patients after UUTC operation(P＜0.05).For the traditional prediction scheme,the area under the curve(AUC)of diabetes,stone diameter,urinary tract obstruction,hydronephrosis,type of preoperative antimicrobial agents used,and duration of preoperative antimicrobial agent use in combination to predict infection in patients with UUTC was 0.856.For the new prediction scheme,the AUC of combined prediction of serum PCT,TNF-α and DcR3 levels was 0.927.The AUC of the combination of the new prediction scheme for prediction was significantly greater than that of the traditional prediction scheme(P＜0.05).Conclusion The risk factors of UTI in patients with UUTC after operation are diabetes mellitus,stone diameter,urinary tract obstruction,hydronephrosis,type of preoperative antimicrobial agents used,duration of preoperative antimicrobial agent use,serum PCT,TNF-α and DcR3 levels,which warrant attention of clinicians.The combined predictive value of serum PCT,TNF-α and DcR3 levels is higher in patients with UTI.