Onodera S, Hosobe T, Machida T, Kurosaka K, Oomayu S
Department of Urology, Jikei Aoto Hospital.
Kansenshogaku Zasshi. 1991 Mar;65(3):311-8. doi: 10.11150/kansenshogakuzasshi1970.65.311.
Clinical backgrounds of 35 patients with urogenital infection, from whom methicillin-resistant Staphylococcus aureus (MRSA) was isolated, were analyzed. Susceptibilities of these MRSA strains to various antimicrobial agents were also measured. Out of 35 MRSA strains, 29, 4 and 2 were isolated from urine, pus and sputum specimens, respectively, showing a definitely high isolation rate from urine. As for underlying diseases, 22 patients (62.8%), 11 (31.4%) and one each had a malignant tumor of the urinary tract or genital organ, prostatic hypertrophy, urolithiasis and vesicoureteral reflux, respectively. Patients aged at over 60 years numbered 20 (57%), and 32 patients (91.4%) were treated with some antimicrobial agent at the time of MRSA isolation. Out of 35 strains, 17 were isolated after total cystectomy with urinary diversion or transurethral surgery. As for the state of MRSA infection, 9 and 26 patients had single and polymicrobial infections, respectively, but none of patients had serious symptoms definitely thought to be caused by MRSA. On evaluation of susceptibilities of MRSA to various antimicrobial agents, the MRSA strains were found to be sensitive to minocycline, netilmicin and ofloxacin. From these results, MRSA strains isolated from patients treated in the field of urology were thought to rarely cause serious infectious symptoms, especially true for those isolated from the urine.
对35例分离出耐甲氧西林金黄色葡萄球菌(MRSA)的泌尿生殖系统感染患者的临床背景进行了分析。还测定了这些MRSA菌株对各种抗菌药物的敏感性。在35株MRSA菌株中,分别从尿液、脓液和痰液标本中分离出29株、4株和2株,尿液中的分离率明显较高。至于基础疾病,22例患者(62.8%)、11例(31.4%)和各1例分别患有泌尿系统或生殖器官恶性肿瘤、前列腺肥大、尿路结石和膀胱输尿管反流。60岁以上的患者有20例(57%),32例患者(91.4%)在分离出MRSA时接受了某种抗菌药物治疗。在35株菌株中,17株是在膀胱全切并尿流改道或经尿道手术后分离出来的。至于MRSA感染状态,9例和26例患者分别为单一感染和多微生物感染,但无一例患者有明确认为由MRSA引起的严重症状。在评估MRSA对各种抗菌药物的敏感性时,发现MRSA菌株对米诺环素、奈替米星和氧氟沙星敏感。从这些结果来看,从泌尿外科治疗的患者中分离出的MRSA菌株很少引起严重的感染症状,从尿液中分离出的菌株尤其如此。