INFECTIOUS COMPLICATIONS OF UROLOGICAL INTERVENTIONS FOR UROLITHIASIS. LITERATURE REVIEW

Abstract

Introduction. The problem of infectious complications of urological interventions for urolithiasis is very relevant today. This is primarily due to the sharply increased number of endoscopic interventions in recent years, the uncontrolled use of antibiotics, and the increasingly significant growth of so-called multidrug-resistant strains of microorganisms. Purpose of the study: to determine the main infectious complications of urological interventions for urolithiasis Search strategy: A literature review of publications from the past 10 years was conducted in the PubMed, CyberLeninka, and Google Scholar databases. The main keywords included: urolithiasis, infectious complications, antibiotic resistance, and postoperative complications. Results: We have reviewed the literature on this topic. Currently, scientists distinguish two main ways of penetration of microorganisms into the urinary tract: endogenous and exogenous ways. With an exogenous route of infection, the sources of UTIs are patients with purulent-septic forms of urogenital and other surgical diseases, bacteria carriers among patients and medical personnel. With the endogenous route of infection, pathogenic microorganisms penetrate the urinary tract from closely located organs (often the pelvic organs): vagina, rectum. Often, infectious complications occur at the hospital stage in patients who have undergone surgical interventions or diagnostic manipulations, including for urolithiasis. The management of patients with similar nosocomial infections of the genitourinary system (NIMPS) and infections of the surgical field (IOP) is quite difficult, since their causative agents, as a rule, are gram-negative microorganisms with increased resistance to antimicrobial drugs. Conclusions. According to many researchers, the frequency of infectious and inflammatory complications after endoscopic interventions for urolithiasis depends on many factors, the main of which are the presence of an initial urinary tract infection. Therefore, patients with baseline BMI, intra- and postoperative complications during endoscopic interventions for urolithiasis should be carefully analyzed, taking into account all the risks of surgical intervention. This review of the literature touches upon the main points in the infection pathway, the main pathogens and various approaches to the treatment and prevention of infectious complications of urological interventions for urolithiasis.