Osterberg E, Hallander H O, Kallner A, Lundin A, Svensson S B, Aberg H
Department of Family Medicine, Karolinska Institute, Stockholm, Sweden.
Scand J Infect Dis. 1990;22(4):477-84. doi: 10.3109/00365549009027080.
Female patients with symptoms of urinary tract infection (n = 1136) were studied in primary health care with respect to (a) clinical symptoms as predictors of bacteriuria; (b) relation between aetiological agent and clinical picture, especially for P-fimbriated Escherichia coli; and (c) clinical findings in cases with 10(2)- less than 10(5) CFU/ml of E. coli. Prevalence of bacteriuria (greater than or equal to 10(5) CFU/ml) was 61%. Concurrence of urgency/frequency and dysuria, short duration of symptoms and hematuria increased the probability of bacteriuria and were also significantly more frequent among cases with low counts of E. coli (10(2) less than 10(5) CFU/ml in pure culture or mixed flora) than among cases with sterile urine, indicating an aetiological role of E. coli in many of those cases. Infections with P-fimbriated E. coli were as benign as the P-fimbriae-negative. The rate of P-fimbriation was 29% in specimens containing greater than or equal to 10(5) CFU/ml of E. coli, 30% among specimens with less than 10(5) CFU/ml in pure culture and 10% in specimens containing less than 10(5) CFU/ml of E. coli in mixed culture. Patients infected with Klebsiella, Enterobacter or Proteus did not show a higher rate of previous urinary tract disease or anomalies.
对1136名有尿路感染症状的女性患者在初级卫生保健机构进行了研究，内容包括：(a) 作为菌尿预测指标的临床症状；(b) 病原体与临床表现之间的关系，特别是针对有P菌毛的大肠杆菌；(c) 每毫升尿液中大肠杆菌菌落形成单位（CFU）数为10²至不足10⁵时的临床发现。菌尿（≥10⁵CFU/ml）的患病率为61%。尿急/尿频和尿痛同时出现、症状持续时间短以及血尿会增加菌尿的可能性，并且在大肠杆菌计数低的病例（纯培养或混合菌群中每毫升尿液含10²至不足10⁵CFU）中也明显比无菌尿的病例更常见，这表明在许多此类病例中大肠杆菌具有病因学作用。有P菌毛的大肠杆菌感染与无P菌毛的感染一样良性。在每毫升尿液中大肠杆菌菌落形成单位数≥10⁵CFU的标本中，P菌毛形成率为29%；在纯培养中每毫升尿液含大肠杆菌菌落形成单位数不足10⁵CFU的标本中为30%；在混合培养中每毫升尿液含大肠杆菌菌落形成单位数不足10⁵CFU的标本中为10%。感染克雷伯菌、肠杆菌或变形杆菌的患者既往泌尿系统疾病或异常的发生率并未更高。
