Shiina H, Himeno Y, Ishibe T
Department of Urology, Shimane Medical University, Izumo-shi, Japan.
Urol Int. 1992;48(2):187-90. doi: 10.1159/000282328.
On 24 benign prostatic hyperplasia patients with preoperatively sterile urine, who also had no history of urinary tract infection, the organisms in the prostate obtained through transurethral resection as well as in the anterior urethra were isolated. In 17 patients out of 24, organisms obtained in the prostate were identical to those in the anterior urethra; therefore, it can be concluded that another 7 patients had organisms in the prostate itself before the operation. These results would suggest that sterile urine did not indicate sterile prostate and that organisms in the prostate did not always ascend from the urethra. In the patients who preoperatively received transurethral catheterizations, Streptococcus faecalis was the most predominantly isolated organism in the prostate, which was highly sensitive to ABPC and minocycline and lower to cephems. On the other hand, in the patients with no history of catheterizations, Staphylococcus epidermidis was the most commonly isolated one, which was highly sensitive to ABPC and minocycline as well as cephems. So, in the treatment of the cases with infectious symptoms after transurethral resection of the prostate, ABPC or minocycline should be selected as first-choice drugs rather than cephems.
对24例术前尿无菌且无尿路感染史的良性前列腺增生患者,通过经尿道切除术获取前列腺及前尿道的微生物并进行分离。24例患者中有17例,前列腺中获取的微生物与前尿道中的相同;因此,可以得出结论,另外7例患者在手术前前列腺本身就存在微生物。这些结果表明,无菌尿并不意味着前列腺无菌,且前列腺中的微生物并非总是从尿道上行而来。在术前接受过经尿道插管的患者中,粪肠球菌是前列腺中最主要分离出的微生物,对氨苄青霉素(ABPC)和米诺环素高度敏感,对头孢菌素敏感性较低。另一方面,在无插管史的患者中,表皮葡萄球菌是最常分离出的微生物,对ABPC、米诺环素和头孢菌素均高度敏感。所以,在经尿道前列腺切除术后有感染症状的病例治疗中,应选择ABPC或米诺环素作为首选药物,而非头孢菌素。