Goya N, Takahashi K, Tanabe K, Osanai K, Asahina Y, Oba S, Ebihara K, Nakamura R, Nakazawa H, Toma H
Department of Urology, Tokyo Women's Medical College.
Nihon Hinyokika Gakkai Zasshi. 1991 Jun;82(6):947-54. doi: 10.5980/jpnjurol1989.82.947.
The clinical state of bacteriuria and its correlation with pyuria and symptomatic genitourinary tract infection (GUTI) were studied in 42 renal transplantation recipients who were followed up in the Kidney Center of Tokyo Women's Medical College over 6 months and who showed bacteriuria more than 3 times between January and December in 1987. The results were as follows. 1) Of the 42 recipients, bacteriuria was found less than 5 times in 19 patients, 6 to 10 times in 18 patients and more than 11 times in 5 patients. There was a tendency for the same bacteria to be isolated several times from the same patient. The most commonly isolated bacterias were Enterobacter, Enterococcus, Serratia and E. coli. 2) Bacteriuria was accompanied by pyuria in 33 patients (79%) and by symptomatic GUTI in 12 patients (29%). Bacteriuria without pyuria was shown in 9 patients (21%) without symptomatic GUTI and it was suggested that bacteriuria did not result in graft hypofunction after two years. 3) Of 16 patients with bacteriuria accompanied by pyuria, symptomatic GUTI occurred in 9 patients (56%). Of these, one patient was found to have VUR of the transplanted kidney, another was found to have VUR of the native kidney, and a third patient died due to interstitial pneumonitis presumably as a result of overimmunosuppression. Transplantation recipients with bacteriuria accompanied by pyuria develop symptomatic GUTIs frequently and should be treated with proper antibacterial agents. When bacteriuria continues, further examination should be performed for an organic disease of the urinary tract or an overimmunosuppressed state. When a patient shows bacteriuria without pyuria, chemotherapy is not needed and it is sufficient to observe the course carefully.
对42例肾移植受者的菌尿临床状态及其与脓尿和症状性泌尿生殖道感染（GUTI）的相关性进行了研究。这些患者在东京女子医科大学肾脏中心随访超过6个月，且在1987年1月至12月期间菌尿出现超过3次。结果如下：1）42例受者中，19例菌尿出现少于5次，18例出现6至10次，5例出现超过11次。同一患者多次分离出相同细菌有一定趋势。最常分离出的细菌为肠杆菌属、肠球菌属、沙雷菌属和大肠杆菌。2）33例患者（79%）菌尿伴有脓尿，12例患者（29%）伴有症状性GUTI。9例患者（21%）菌尿无脓尿且无症状性GUTI，提示菌尿两年后未导致移植物功能减退。3）16例菌尿伴有脓尿的患者中，9例（56%）出现症状性GUTI。其中，1例患者移植肾存在膀胱输尿管反流（VUR），另1例患者自体肾存在VUR，第3例患者因可能由于免疫抑制过度导致的间质性肺炎死亡。菌尿伴有脓尿的移植受者频繁发生症状性GUTI，应使用适当抗菌药物治疗。当菌尿持续存在时，应进一步检查是否存在泌尿系统器质性疾病或免疫抑制过度状态。当患者菌尿无脓尿时，无需化疗，仔细观察病程即可。
