del Río G, Mestre J, Dalet F
Servicio de Nefrología, Fundación Puigvert, Barcelona.
Enferm Infecc Microbiol Clin. 1992 Dec;10(10):602-6.
The aim of this study was to evaluate the prevalence of asymptomatic bacteriuria and its prognostic factors in a geriatric population living in a nursing home. Seventy-eight patients (68 females, 10 males) with a mean age of 82 +/- 6 years (range: 60-94) were studied. Once symptomatic infection is ruled out and the risk factors had been analyzed, a urine culture was performed in all cases. We then identified two different population groups: asymptomatic bacteriuria without risk factors (group A), and asymptomatic bacteriuria with risk factors (group B). Overall prevalence of asymptomatic bacteriuria was 38.5% (Group A: 23%, group B: 63%; p < 0.001). Considering all patients with bacteriuria, 50% of cases (15 out of 30 patients) had urine incontinence, 40% suffer from severe limitation of movements and 70% had a past history of pregnancy. The same figures for the population with negative urine culture were 12.5%, 14.5%, and 46% respectively (p < 0.01). In group B, 79% of cases had more than one RF, including all patients with the association of urine incontinence, movement limitation and diabetes. In group A, 93% of asymptomatic bacteriuria were due to E. coli with low adhesin expression (27%) whereas in group B, E. coli was isolated in 44% asymptomatic bacteriuria cases, with high adhesin expression (71.5%), other enteric gram-negative bacilli (31%), non-fermentative gram-negative bacilli (19%) and gram-positive cocci (6%). Group A patients were treated with a single dose of ciprofloxacin (500 mg) with elimination of bacteria in urine in 91% of cases (at one week) and 73% of cases (at one month).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在评估生活在养老院的老年人群中无症状菌尿的患病率及其预后因素。研究了78例患者(68名女性,10名男性),平均年龄为82±6岁(范围:60 - 94岁)。在排除症状性感染并分析危险因素后,对所有病例进行了尿培养。然后我们确定了两个不同的人群组:无危险因素的无症状菌尿(A组)和有危险因素的无症状菌尿(B组)。无症状菌尿的总体患病率为38.5%(A组:23%,B组:63%;p<0.001)。在所有菌尿患者中,50%的病例(30例患者中的15例)有尿失禁,40%有严重运动受限,70%有既往妊娠史。尿培养阴性人群的相应数字分别为12.5%、14.5%和46%(p<0.01)。在B组中,79%的病例有不止一种危险因素,包括所有同时存在尿失禁、运动受限和糖尿病的患者。在A组中,93%的无症状菌尿是由低粘附素表达的大肠杆菌引起的(27%),而在B组中,44%的无症状菌尿病例分离出大肠杆菌,其中高粘附素表达的占71.5%,其他肠道革兰氏阴性杆菌占31%,非发酵革兰氏阴性杆菌占19%,革兰氏阳性球菌占6%。A组患者接受单剂量环丙沙星(500毫克)治疗,91%的病例(一周时)和73%的病例(一个月时)尿液中的细菌被清除。(摘要截断于250字)