Meissner A, Mamoulakis C, Laube N
Academic Medical Center, Department of Urology, University of Amsterdam, Meibergdreef 9, NL-1105, AZ Amsterdam, Niederlande.
Urologe A. 2010 May;49(5):623-8. doi: 10.1007/s00120-010-2257-0.
The classic "infection stone" struvite is formed as a result of metabolic activity of urease-positive bacteria from alkaline urine with pH-values above 7.5. Due to improved infection diagnostics and antibiotic therapy, the occurrence of infection-related urinary stones in the western industrialized world decreases, despite the generally increasing prevalence rates of urolithiasis in these societies. Struvite is often associated with other mineral phases. These accessory mineral phases could indicate other, non-infection-related causes of urinary stone formation. Thus, mineral analysis is always recommended. Struvite stones as well as struvite encrustations on urinary tract implants are characterized by rapid growth. The rapid growth-related embedding of urease-positive bacteria in the crystalline material makes the urinary stone a persistent source of recurrent urinary tract infections. According to the German Society of Urology guidelines on urolithiasis, a patient with the diagnosis "infection stone" should be assigned to the "high-risk" patient group. Complete stone and debris removal, as well as a special metaphylaxis strategy are required to initiate successful stone therapy.
典型的“感染性结石”鸟粪石是由pH值高于7.5的碱性尿液中尿素酶阳性细菌的代谢活动形成的。尽管西方工业化社会中尿石症的总体患病率普遍上升，但由于感染诊断和抗生素治疗的改善，这些社会中与感染相关的尿路结石的发生率有所下降。鸟粪石通常与其他矿物相有关。这些附属矿物相可能表明尿路结石形成的其他非感染相关原因。因此，始终建议进行矿物分析。尿路结石以及尿路植入物上的鸟粪石结痂的特点是生长迅速。尿素酶阳性细菌与快速生长相关地嵌入晶体物质中，使尿路结石成为复发性尿路感染的持续来源。根据德国泌尿外科学会关于尿石症的指南，诊断为“感染性结石”的患者应归入“高危”患者组。要启动成功的结石治疗，需要完全清除结石和碎片，以及采取特殊的预防策略。
