Schlager T A, Hendley J O, Wilson R A, Simon V, Whittam T S
Department of Pediatrics and Emergency Medicine, University of Virginia, Charlottesville, USA.
Clin Infect Dis. 1999 Feb;28(2):346-50. doi: 10.1086/515134.
Periurethral bacteria are inoculated daily into the urine of children with neurogenic bladder during clean intermittent catheterization (CIC). We examined how frequently periurethral bacterial species produced bacteriuria in children followed longitudinally. When Escherichia coli was detected on the periurethra, bacteriuria was also present 93% of the time. When Klebsiella, Pseudomonas, or Enterococcus species or nonpathogens were detected on the periurethra, bacteriuria was present 80%, 40%, 40%, and 25% of the time, respectively. Clonal typing of multiple colonies of E. coli from each periurethral and urine culture revealed that children carried only one or two E. coli clones in their urinary tracts over months of surveillance. When E. coli was detected in the urine, the identical clone was on the periurethra. E. coli persisted for weeks in the urine without causing symptoms. Occasionally the same E. coli clone carried for weeks caused a urinary tract infection. Bacteriuria frequently occurs after inoculation of periurethral E. coli into the urine during CIC.
在间歇性清洁导尿（CIC）过程中，尿道周围细菌每天都会接种到神经源性膀胱患儿的尿液中。我们纵向观察了尿道周围细菌种类在患儿中引起菌尿的频率。当在尿道周围检测到大肠杆菌时，93%的情况下也会出现菌尿。当在尿道周围检测到克雷伯菌、假单胞菌、肠球菌或非病原菌时，菌尿出现的时间分别为80%、40%、40%和25%。对每次尿道周围和尿液培养中多个大肠杆菌菌落进行克隆分型，结果显示在数月的监测期内，患儿尿路中仅携带一两种大肠杆菌克隆。当尿液中检测到大肠杆菌时，尿道周围存在相同的克隆。大肠杆菌可在尿液中持续数周而不引起症状。偶尔，携带数周的相同大肠杆菌克隆会引发尿路感染。在CIC过程中，将尿道周围的大肠杆菌接种到尿液后，菌尿经常发生。
