Darouiche R O, Donovan W H, Del Terzo M, Thornby J I, Rudy D C, Hull R A
Veterans Affairs Medical Center, Houston, Texas, USA.
Urology. 2001 Sep;58(3):339-44. doi: 10.1016/s0090-4295(01)01271-7.
To examine the safety and efficacy of bacterial interference in preventing symptomatic urinary tract infection (UTI).
A prospective, nonrandomized, pilot clinical trial was conducted in patients with spinal cord injury who had neurogenic bladder and had frequent episodes of symptomatic UTI. The bladder of patients was inoculated with a nonpathogenic prototype of Escherichia coli 83972. The rate of symptomatic UTI in successfully colonized patients while colonized with E. coli 83972 was compared with (a) their own baseline prestudy rate and (b) the rate of symptomatic UTI in patients who were not successfully colonized.
Of 44 inoculated patients, 30 (68%) became colonized with E. coli 83972 for 1 month or longer. Only two episodes of symptomatic UTI occurred in the group of 30 patients while colonized with E. coli 83972 (a total of 34 patient-years), and none was attributed to E. coli 83972. The group of 30 patients experienced a 63-fold reduction in the rate of symptomatic UTI while colonized with E. coli 83972 versus their baseline prestudy period (mean 0.06 versus 3.77 episodes of symptomatic UTI/patient-year, P <0.001). The rate of symptomatic UTI was also 33-fold lower in this group of 30 patients while colonized with E. coli 83972 than in the well-matched group of 14 patients who were not successfully colonized (mean 0.06 versus 1.80 episodes of symptomatic UTI/patient-year, P <0.001).
The results of this pilot study indicate that bacterial interference using E. coli 83972 may be safe and effective in preventing UTI.
研究细菌干扰预防有症状性尿路感染（UTI）的安全性和有效性。
对患有神经源性膀胱且有频繁有症状性UTI发作的脊髓损伤患者进行了一项前瞻性、非随机的试点临床试验。给患者膀胱接种非致病性大肠杆菌83972原型菌株。将成功定植大肠杆菌83972的患者在定植期间有症状性UTI的发生率与（a）他们自身研究前的基线发生率以及（b）未成功定植患者有症状性UTI的发生率进行比较。
44例接种患者中，30例（68%）被大肠杆菌83972定植达1个月或更长时间。在这30例被大肠杆菌83972定植的患者组中（总计34患者年）仅发生了2次有症状性UTI发作，且均不归因于大肠杆菌83972。与研究前基线期相比，这30例患者在被大肠杆菌83972定植期间有症状性UTI的发生率降低了63倍（有症状性UTI的平均发生率分别为0.06次/患者年和3.77次/患者年，P<0.001）。这30例患者在被大肠杆菌83972定植期间有症状性UTI的发生率也比14例未成功定植的匹配良好的患者组低33倍（有症状性UTI的平均发生率分别为0.06次/患者年和1.80次/患者年，P<0.001）。
这项试点研究的结果表明，使用大肠杆菌83972进行细菌干扰在预防UTI方面可能是安全有效的。
