Magnesium-ammonium phosphate stones are usually secondary to urinary tract infection with which of the following:
Magnesium-ammonium-phosphate stones are usually secondary to urinary tract infection with bacteria that produce urease (primarily Proteus species). The urease hydrolyzes the urea producing ammonia and thereby raising the pH as well as providing the source of ammonia. Eradication of the infection prevents fuher stone formation. After calculi removal, prevention of stone growth is best accomplished by urinary acidification, long-term use of antibiotics, and the use of acetohydroxamic acid (a urease inhibitor that maintains an acid urinary pH). Ref: Obrador G.T. (2009). Chapter 17. Chronic Renal Failure & the Uremic Syndrome. In E.V. Lerma, J.S. Berns, A.R. Nissenson (Eds), CURRENT Diagnosis & Treatment: Nephrology & Hypeension.
Escherichia coli
Proteus species
Klebsiella
Enterococcus