Kumamoto Yoshiaki, Tsukamoto Taiji, Fujime Makoto, Fujita Kazuhiko, Hirose Takaoki, Matsukawa Masanori, Takahashi Satoshi, Kunishima Yasuharu, Igari Jun, Ogihara Masahiko, Ishibashi Kei, Oguri Toyoko, Shigeta Shiro, Yamaguchi Keizo, Matsumoto Tetsuya, Kashitani Fusako, Yoshida Hiroshi, Imafuku Yuuji, Murai Masaru, Ooe Hiroshi, Nishikawa Mineko, Watanabe Kiyoaki, Kobayashi Yoshio, Uchida Hiroshi, Oka Toshitsugu, Kitamura Masaya, Takano Yuuji, Matsuoka Yasuhiro, Matsuda Seiji, Sato Shinichi, Furuhama Toshinari, Kumon Hiromi, Monden Koichi, Aoki Siho, Mochida Chikako, Hirakata Yoichi, Kohno Shigeru, Miyazaki Yoshitsugu, Tomono Kazunori
Department of Urology, Sapporo Medical University, School of Medicine.
Jpn J Antibiot. 2002 Aug;55(4):399-411.
Five-hundred eighty eight bacterial strains isolated from 435 patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between August 2000 and July 2001. Then, the clinical background of patients were investigated such as sex, age, and type of infections, infections and kind of bacteria, frequency of bacteria isolation by age and infections, bacteria and infections by timing of antibiotics administration, and bacteria and infections by surgical procedures. About the relationship between age and sex of patients and type of infections, the number of male patients aged less than 50 years was few, and complicated UTIs without indwelling catheter was the most frequent. In females, the number of patients aged less than 20 years was few. The majority of female patients aged 40 years and over had complicated UTIs while uncomplicated UTIs was most frequent in the patients being twenties. As for type of infections and kind of bacteria, Escherichia coli decreased when the infections became complicated, and pseudomonas aeruginosa increased when the infection became complicated. Enterococcus faecalis was isolated more frequently in complicated UTIs than in uncomplicated UTIs. Considering this result by age of patients, isolated frequency of E. coli was gradually decreased with aging in patients aged 20 years and over with uncomplicated UTIs or complicated UTIs without indwelling catheter. The isolated frequencies of Klebsiella spp., P. aeruginosa, and E. faecalis were high in the patients with complicated UTIs without indwelling catheter. In the patients aged 70 years and over with complicated UTIs with indwelling catheter, P. aeruginosa and E. faecalis were frequently isolated. As for type of causative organisms in UTIs before and after the administration of antibiotics, the isolation of bacteria was remarkably decreased after administration in the patients with uncomplicated UTIs and complicated UTIs without indwelling catheter. E. coli decreased after administration of antibiotics, and P. aeruginosa increased after administration in the patients with all types of infections. As for type of causative organisms in UTIs and surgical procedures, E. coli was frequently isolated in the patients without surgery in all types of infections, while P. aeruginosa was frequently isolated in the patients who underwent surgery. In uncomplicated UTIs, Proteus spp. and E. faecalis were frequently isolated in the patients with surgery. In complicated UTIs without indwelling catheter, Klebsiella spp. was frequently isolated in the patients without surgery and E. faecalis was frequently isolated in the patients with surgery. In complicated UTIs with indwelling catheter, most of organisms except P. aeruginosa and S. aureus were frequently isolated in the patients without surgery.
2000年8月至2001年7月期间,从日本10家机构诊断为患有尿路感染(UTIs)的435名患者中分离出588株细菌菌株。然后,对患者的临床背景进行了调查,如性别、年龄、感染类型、感染与细菌种类、按年龄和感染情况的细菌分离频率、抗生素给药时间与细菌和感染的关系以及手术操作与细菌和感染的关系。关于患者的年龄和性别与感染类型之间的关系,年龄小于50岁的男性患者数量较少,无留置导管的复杂性尿路感染最为常见。在女性中,年龄小于20岁的患者数量较少。40岁及以上的大多数女性患者患有复杂性尿路感染,而20多岁的患者中单纯性尿路感染最为常见。至于感染类型和细菌种类,感染变得复杂时大肠杆菌减少,感染变得复杂时铜绿假单胞菌增加。粪肠球菌在复杂性尿路感染中比在单纯性尿路感染中更频繁地分离出来。考虑到患者年龄的这一结果,在20岁及以上患有单纯性尿路感染或无留置导管的复杂性尿路感染的患者中,大肠杆菌的分离频率随着年龄的增长而逐渐降低。在无留置导管的复杂性尿路感染患者中,克雷伯菌属、铜绿假单胞菌和粪肠球菌的分离频率较高。在70岁及以上患有留置导管的复杂性尿路感染的患者中,铜绿假单胞菌和粪肠球菌经常被分离出来。至于抗生素给药前后尿路感染的病原体类型,在单纯性尿路感染和无留置导管的复杂性尿路感染患者中,给药后细菌的分离显著减少。在所有类型感染的患者中,抗生素给药后大肠杆菌减少,铜绿假单胞菌增加。至于尿路感染的病原体类型和手术操作,在所有类型感染中,未进行手术的患者中经常分离出大肠杆菌,而接受手术的患者中经常分离出铜绿假单胞菌。在单纯性尿路感染中,变形杆菌属和粪肠球菌在接受手术的患者中经常被分离出来。在无留置导管的复杂性尿路感染中,未进行手术的患者中经常分离出克雷伯菌属,接受手术的患者中经常分离出粪肠球菌。在有留置导管的复杂性尿路感染中,除铜绿假单胞菌和金黄色葡萄球菌外,大多数病原体在未进行手术的患者中经常被分离出来。