التفاصيل البيبلوغرافية
| العنوان: |
The Application of Next-Generation Sequencing in Preoperative Evaluation for Urologic Stone Surgery. |
| المؤلفون: |
Jongjitaree K; Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Sheetz T; Department of Urology, University of California San Diego, San Diego, California, USA., Finegan J; Department of Urology, University of California San Diego, San Diego, California, USA., Bechis SK; Department of Urology, University of California San Diego, San Diego, California, USA., Sur RL; Department of Urology, University of California San Diego, San Diego, California, USA., Monga M; Department of Urology, University of California San Diego, San Diego, California, USA. |
| المصدر: |
Journal of endourology [J Endourol] 2024 Jun 24. Date of Electronic Publication: 2024 Jun 24. |
| Publication Model: |
Ahead of Print |
| نوع المنشور: |
Journal Article |
| اللغة: |
English |
| بيانات الدورية: |
Publisher: Mary Ann Liebert Country of Publication: United States NLM ID: 8807503 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-900X (Electronic) Linking ISSN: 08927790 NLM ISO Abbreviation: J Endourol Subsets: MEDLINE |
| أسماء مطبوعة: |
Original Publication: New York : Mary Ann Liebert, [c1987- |
| مستخلص: |
Introduction: Next-generation sequencing (NGS) is a new molecular technique for identifying microorganisms. Treating bacteriuria in patients undergoing stone removal procedures is important for preventing postoperative urinary tract infection (UTI). The objective of this study is to assess the usefulness of preoperative urine NGS testing by comparing NGS with standard urine culture in predicting postoperative UTI after ureteroscopic lithotripsy (URSL) and percutaneous nephrolithotomy (PCNL). Materials and Methods: This prospective study was conducted from February 16, 2022, to January 11, 2024. Sixty subjects who underwent URSL or PCNL were included. Preoperative voided urine samples were collected for urine culture and tested by MicroGenDX for urine polymerase chain reaction (PCR) and urine NGS. Stone specimens obtained intraoperatively were also sent for stone culture and MicrogenDx. Patients were monitored for 4 weeks post-operation for recording clinical outcomes related to infections and complications. Results: Twenty-six (43.3%) male and 34 (56.7%) female participants were included. Twenty-six (43.3%) patients underwent PCNL (15 standard PCNL and 11 mini PCNL), and 34 (56.7%) underwent URSL. Standard urine culture identified positive results in 26 cases (43.3%), PCR for 17 cases (28.3%), and NGS for 31 cases (51.7%). The overall postoperative UTI rate was 6 (10%). Standard urine culture demonstrated a sensitivity of 50%, specificity of 57.4%, and accuracy of 56.7%. Positive predictive value (PPV) was notably poor at 11.5%. Urine NGS showed a higher sensitivity of 83.3%, specificity of 53.7%, accuracy of 55%, and PPV of 16.7%. Conclusion: Urine NGS significantly improves the sensitivity of detecting microorganisms in preoperative urine compared with standard urine culture. Despite its high sensitivity and capability to identify nonculturable bacteria, using NGS alongside standard urine culture is recommended. This parallel approach harnesses the strengths of both methods. Integrating NGS into standard practice could elevate the quality of care, especially for patients at high risk of UTIs, such as those undergoing invasive stone removal procedures. |
| فهرسة مساهمة: |
Keywords: next-generation sequencing; percutaneous nephrolithotomy; preoperative evaluation; ureteroscopic lithotripsy; urologic stone surgery |
| تواريخ الأحداث: |
Date Created: 20240614 Latest Revision: 20240624 |
| رمز التحديث: |
20240624 |
| DOI: |
10.1089/end.2024.0167 |
| PMID: |
38874261 |
| قاعدة البيانات: |
MEDLINE |
