Center for Biofilm Engineering, Montana State University, Bozeman, MT, USA.
Chemical & Biological Engineering, College of Engineering, Montana State University, Bozeman, MT, USA.
Nat Rev Urol. 2019 Jan;16(1):35-53. doi: 10.1038/s41585-018-0120-z.
Infection stones are complex aggregates of crystals amalgamated in an organic matrix that are strictly associated with urinary tract infections. The management of patients who form infection stones is challenging owing to the complexity of the calculi and high recurrence rates. The formation of infection stones is a multifactorial process that can be driven by urine chemistry, the urine microenvironment, the presence of modulator substances in urine, associations with bacteria, and the development of biofilms. Despite decades of investigation, the mechanisms of infection stone formation are still poorly understood. A mechanistic understanding of the formation and growth of infection stones - including the role of organics in the stone matrix, microorganisms, and biofilms in stone formation and their effect on stone characteristics - and the medical implications of these insights might be crucial for the development of improved treatments. Tools and approaches used in various disciplines (for example, engineering, chemistry, mineralogy, and microbiology) can be applied to further understand the microorganism-mineral interactions that lead to infection stone formation. Thus, the use of integrated multidisciplinary approaches is imperative to improve the diagnosis, prevention, and treatment of infection stones.
感染性结石是一种复杂的晶体聚集体，与有机基质结合在一起，与尿路感染密切相关。由于结石的复杂性和高复发率，感染性结石患者的治疗具有挑战性。感染性结石的形成是一个多因素的过程，可能由尿液化学成分、尿液微环境、尿液中调节剂物质的存在、与细菌的关联以及生物膜的形成所驱动。尽管已经进行了几十年的研究，但感染性结石形成的机制仍知之甚少。对感染性结石形成和生长的机制（包括有机物质在结石基质中的作用、微生物和生物膜在结石形成中的作用及其对结石特征的影响）的深入了解，可能对开发更好的治疗方法至关重要。各种学科（例如工程学、化学、矿物学和微生物学）中使用的工具和方法可用于进一步了解导致感染性结石形成的微生物-矿物质相互作用。因此，必须采用综合多学科方法来改善感染性结石的诊断、预防和治疗。
