{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T08:58:58Z","timestamp":1790499538025,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate whether intrarenal antibiotic-augmented irrigation with neomycin\/polymyxin B during percutaneous nephrolithotomy (PCNL) in patients at high risk for infection was associated with lower postoperative infectious complications and reduced infection-related resource utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We performed a single-center, retrospective matched cohort study of adults undergoing PCNL who were at high risk for infection between January 2020 and December 2024. Fifty patients who received intrarenal neomycin\/polymyxin B irrigation (1 mL GU irrigant per 3-L saline bag) were matched 1:1 to controls receiving standard saline irrigation by age, sex, diabetes, Charlson Comorbidity Index, and preoperative urinary drainage. The primary end-point was symptomatic urinary tract infection (UTI) within 30 days. Secondary outcomes included systemic inflammatory response syndrome (SIRS), sepsis during index hospitalization, infection-related prolonged hospitalization, emergency department visits for infection, and 30-day infection-related readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirty-day UTI occurred in 3\/50 patients (6.0%) in the GU group\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      17\/50 (34.0%) in controls (number needed to treat 3.6;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001). SIRS occurred in 16.0%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      48.0% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001), sepsis during index hospitalization in 0%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      16.0% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.006), and infection-related prolonged hospitalization in 0%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      20.0% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001). In adjusted analysis (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 99), GU irrigation remained independently associated with lower 30-day UTI risk (adjusted OR 0.11, 95% CI 0.03\u20130.44;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002). Short-term renal safety outcomes were comparable between groups. Modeled economic analysis suggested potential net savings of approximately $7800 per patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this matched cohort of PCNL patients at high risk for infection, intrarenal neomycin\/polymyxin B irrigation was associated with substantially lower postoperative infectious morbidity, including elimination of sepsis during index hospitalization, with comparable short-term renal safety outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08927790261491575","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:18:16Z","timestamp":1790317096000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intrarenal Antibiotic Irrigation During Percutaneous Nephrolithotomy Reduces Postoperative Infections and Eliminates Sepsis in High-Risk Patients: A Matched Cohort Study"],"prefix":"10.1177","author":[{"given":"Pengbo","family":"Jiang","sequence":"first","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0290-4316","authenticated-orcid":false,"given":"Bruce M.","family":"Gao","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4765-2759","authenticated-orcid":false,"given":"Harel C.","family":"Sims","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kriselle","family":"Madamba","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle A.","family":"Bociort","sequence":"additional","affiliation":[{"name":"Florida Atlantic University, Boca Raton, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyedamirvala","family":"Saadat","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliott","family":"Freudenburg","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Gryzinski","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymon","family":"Ali","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Hsi","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan M.","family":"Patel","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Landman","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph V.","family":"Clayman","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.05.091"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2424-2"},{"key":"e_1_3_3_4_1","unstructured":"3.Owens P Miller M Barrett M et al. Addendum to HCUP statistical brief #306: Overview of outcomes for inpatient stays involving sepsis 2016\u20132021 Addition of 2022 Data. 2025. Available from: https:\/\/hcup-us.ahrq.gov\/reports\/statbriefs\/sb306-overview-sepsis-2016-2022-addendum.pdf [Last accessed: April15 2026]."},{"key":"e_1_3_3_5_1","unstructured":"4.Owens P Miller M Barrett M et al. Overview of outcomes for inpatient stays involving sepsis 2016\u20132021. 2024. 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