A Study on Metabolic Differences Between Infectious and Non-Infectious Stones in Patients with Urine Culture Positive for Proteus mirabilis

Objective To compare clinical features and identify risk factors for infectious vs. non-infectious stones in patients with Proteus mirabilis -positive urine cultures. Methods We retrospectively analyzed 84 patients with upper urinary tract stones and P. mirabilis urinary tract infection from 2015 to 2020. Patients were categorized based on postoperative stone composition. Demographic and preoperative laboratory data were compared, and multivariate logistic regression was performed. Results Of the 84 patients, 61 (72.6%) had infectious stones and 23 (27.4%) had non-infectious stones. The infectious stone group was younger and had lower BMI (P < 0.05). Non-infectious stone patients had lower 24-hour urine volume (P < 0.05). Multivariate analysis showed that older age, high BMI, and low urine volume were independent risk factors for non-infectious stones, while diabetes predicted infectious stones. Conclusion Non-infectious stone patients should increase fluid intake and manage weight, whereas those with infectious stones—especially diabetic patients—require strict glucose control and active infection management to prevent stone formation.