Senay H, Goetz M B
Sepulveda Veterans Administration Medical Center, California.
J Urol. 1991 Jun;145(6):1201-4. doi: 10.1016/s0022-5347(17)38575-0.
We sought to determine the contribution of pathogen-specific factors to the pathogenesis of invasive urinary tract infections in chronically institutionalized elderly men with symptomatic bacteriuria. We found that Escherichia coli was the most invasive pathogen, being found in 46% of the bacteremic as opposed to 25% of the nonbacteremic, rigorously defined urinary tract infections (p less than 0.01). The predominance of E. coli in bacteremic urinary tract infections was observed regardless of whether indwelling urinary drainage devices were used. The finding that E. coli accounted for a greater proportion of bacteremic than nonbacteremic urinary tract infections indicates that bacteremia arising from the geriatric urinary tract is not simply a consequence of mechanical factors, such as urinary tract obstruction. Thus, further investigations are warranted to assess the specific contribution of previously defined E. coli virulence factors to the pathogenesis of urinary tract infections in such patients.
我们试图确定病原体特异性因素对患有症状性菌尿的长期机构化老年男性侵袭性尿路感染发病机制的影响。我们发现，大肠杆菌是最具侵袭性的病原体，在46%的菌血症性尿路感染中被发现，而在严格定义的非菌血症性尿路感染中这一比例为25%（p小于0.01）。无论是否使用留置导尿装置，均观察到大肠杆菌在菌血症性尿路感染中占主导地位。大肠杆菌在菌血症性尿路感染中所占比例高于非菌血症性尿路感染这一发现表明，老年患者尿路引起的菌血症并非仅仅是机械性因素（如尿路梗阻）的结果。因此，有必要进行进一步研究，以评估先前确定的大肠杆菌毒力因子对此类患者尿路感染发病机制的具体影响。
