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[良性前列腺增生患者术前尿培养与前列腺培养之间的关系]

[Relationship between preoperative urine cultures and prostatic gland cultures in patients treated for benign prostatic hyperplasia].

作者信息

Soler Soler J L, Hidalgo Domínguez M R, Martínez Torres J L, Zuluaga Gómez A, Nogueras Ocaña M, Lardelli Claret P, Liébana Ureña J, Saharour G

机构信息

Servicio de Urología, Hospital Torrecárdenas Almería.

出版信息

Actas Urol Esp. 1999 Jun;23(6):505-17.

Abstract

OBJECTIVES

1.--Investigate the bacteriuria preoperative in patients who will be operate on for Being Prostatic Hyperplasia (BPH). 2.--Define the prevalence of the prostatic colonization or infection. 3.--Try to correlate the bacteriological findings of urine and prostate, and find the degree of concordance between the microorganisms which can be commonly found in urine and prostatic tissue.

METHOD AND MATERIALS

Prospective series of 175 patients undergoing prostatectomy for obstructive symptoms. The protocol revealed, among others variables: the preoperative urine culture; the presence or the absence of catheter; and the quantitative bacteriological culture of prostatic tissue. The information could be analised and its results could be obtained later on. The analysis stages consisted of both a descriptive and an analytic study.

RESULTS AND CONCLUSIONS

1.--Only 36 patients (20.6%) presented bacteriological increase of microorganisms (> or = 10(4) UFC/ml) in the preoperative urine culture. The Escherichia coli was the most common microorganism, followed by the Enterococcus faecalis, coagulase-negative Staphylococcus and the Pseudomona aeruginosa. A single microorganism grew in 31 out of the 36 positive cultures. 2.--The prevalence of the infection or colonization of the prostatic tissue was 25.1% (44 patients). The most common isolated microorganism was the coagulase-negative Staphylococcus followed by the Escherichia coli and the Enterococcus faecalis, in concentrations of at least 10(4) UFC/gr of tissue in the 79.6%. A single microorganism was isolated in 32 out of 44 patients. 3.--The proportion of positive prostatic cultures, in patients with positive urine culture (38.3%), was significantly higher than the one obtained in patients with negative urine cultures (16.5%) (p < 0.0001). Nevertheless, 52.3% of the 44 patients with positive prostatic cultures had negative urine culture, and only 21 (58.3%) out of the 36 patients with positive urine cultures presented a bacteriological growth in prostate. The degree of concordance (Kappa index) between the microorganisms which were found in preoperative urine and prostatic tissue is low or none for the majority of them.

摘要

目的

  1. 调查因前列腺增生(BPH)接受手术患者的术前菌尿情况。2. 确定前列腺定植或感染的患病率。3. 尝试关联尿液和前列腺的细菌学检查结果,找出尿液和前列腺组织中常见微生物的一致程度。

方法和材料

对175例因梗阻症状接受前列腺切除术的患者进行前瞻性研究。该方案揭示了除其他变量外的以下内容:术前尿培养;是否存在导尿管;以及前列腺组织的定量细菌培养。这些信息可以进行分析,之后可以得到结果。分析阶段包括描述性研究和分析性研究。

结果与结论

  1. 术前尿培养中仅36例患者(20.6%)出现微生物细菌学增加(≥10⁴CFU/ml)。大肠杆菌是最常见的微生物,其次是粪肠球菌、凝固酶阴性葡萄球菌和铜绿假单胞菌。36份阳性培养物中有31份仅生长单一微生物。2. 前列腺组织感染或定植的患病率为25.1%(44例患者)。最常见的分离微生物是凝固酶阴性葡萄球菌,其次是大肠杆菌和粪肠球菌,79.6%的组织浓度至少为10⁴CFU/g。44例患者中有32例分离出单一微生物。3. 尿培养阳性患者中前列腺培养阳性的比例(38.3%)显著高于尿培养阴性患者(16.5%)(p<0.0001)。然而,44例前列腺培养阳性患者中有52.3%尿培养阴性,36例尿培养阳性患者中只有21例(58.3%)前列腺有细菌生长。术前尿液和前列腺组织中发现的微生物之间的一致程度(kappa指数)对于大多数微生物来说较低或无一致性。

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