A study on metabolic differences between infectious and non-infectious stones in patients with urine culture positive for Proteus mirabilis

Abstract Objective To compare the clinical characteristics of infectious and non-infectious stones in patients with urinary tract infections caused by Proteus mirabilis and to explore associated influencing factors. Methods Clinical data from 93 patients with upper urinary tract stones and concomitant Proteus mirabilis urinary tract infection treated between 2015 and 2021 were retrospectively analyzed. Patients were classified according to postoperative stone composition. Demographic characteristics and preoperative laboratory parameters were compared between groups, and multivariate logistic regression analysis was performed to identify factors associated with infectious stones. Results Of the 93 patients included, 70 (75.3%) had infectious stones and 23 (24.7%) had non-infectious stones. Patients in the infectious stone group were younger and had a lower body mass index (BMI) than those in the non-infectious stone group (P < 0.05). The 24-h urine volume was significantly lower in the non-infectious stone group (P < 0.05). Multivariate analysis showed that older age, higher BMI, and lower urine volume were significantly negatively associated with the presence of infectious stones, whereas diabetes mellitus was significantly associated with infectious stones. Conclusion Patients with non-infectious stones should be advised to increase fluid intake and manage body weight. In contrast, patients with infectious stones, particularly those with concomitant diabetes mellitus, require strict glycemic control and active anti-infective treatment to reduce the risk of stone formation.