Falcou L, Davido B, Even A, Bouchand F, Salomon J, Sotto A, Denys P, Dinh A
Unité d'urodynamique, hôpital universitaire R.-Poincaré, UVSQ, AP-HP, 92380 Garches, France.
Unité de maladies infectieuses, hôpital universitaire R.-Poincaré, UVSQ, AP-HP, 104, boulevard R.-Poincaré, 92380 Garches, France.
Prog Urol. 2018 May;28(6):307-314. doi: 10.1016/j.purol.2018.03.002. Epub 2018 Apr 24.
Urinary tract infection (UTI) is the most common complication in patients with neurogenic bladder. The long-term use of antibiotic drugs induces an increase in antimicrobial resistance and adverse drug reactions. Bacterial interference is a new concept to prevent recurrent UTI which consists in a bladder colonization with low virulence bacteria. We performed a literature review on this emerging therapy.
Literature review of bacterial interference to prevent symptomatic urinary tract infection in neurological population.
Seven prospectives study including 3 randomized, double-blind and placebo controlled trial were analyzed. The neurological population was spinal cord injured in most cases. The bladder colonization was performed with 2 non-pathogen strains of Escherichia coli: HU 2117 and 83972. At 1 month, 38 to 83% of patients were colonized. Mean duration of colonization was 48.5 days to 12.3 months. All studies showed that colonization might reduce the number of urinary tract infections and is safe with absence of serious side effects.
Bacterial interference is a promising alternative therapy for the prevention of recurrent symptomatic urinary tract infections in neurogenic patients. This therapy should have developments for a daily use practice and for a long-term efficacy.
尿路感染（UTI）是神经源性膀胱患者最常见的并发症。长期使用抗生素会导致抗菌药物耐药性增加和药物不良反应。细菌干扰是预防复发性UTI的一个新概念，它是指用低毒力细菌定植膀胱。我们对这种新兴疗法进行了文献综述。
对细菌干扰预防神经源性人群有症状尿路感染的文献进行综述。
分析了7项前瞻性研究，其中包括3项随机、双盲和安慰剂对照试验。大多数情况下，神经源性人群为脊髓损伤患者。膀胱定植使用2种非致病性大肠杆菌菌株：HU 2117和83972。1个月时，38%至83%的患者实现了定植。定植的平均持续时间为48.5天至12.3个月。所有研究均表明，定植可减少尿路感染的次数，且安全无严重副作用。
细菌干扰是预防神经源性患者复发性有症状尿路感染的一种有前景的替代疗法。这种疗法应在日常应用和长期疗效方面取得进展。
