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磷霉素氨丁三醇对尿路感染结石内细菌的抗菌作用。

Antibacterial effect of fosfomycin tromethamine on the bacteria inside urinary infection stones.

机构信息

Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Int Urol Nephrol. 2020 Apr;52(4):645-654. doi: 10.1007/s11255-019-02358-0. Epub 2019 Dec 12.

Abstract

OBJECTIVE

This study sought to evaluate the antibacterial effect of fosfomycin tromethamine (FT) on the bacteria inside urinary infection stones.

METHODS

The internal structures of urinary stones were observed via scanning electron microscopy to verify the presence of internal bacteria. We randomly assigned equal numbers of patients with kidney stones who met the inclusion criteria into two groups in a prospective study and treated them with different perioperative antibiotics. One group (experimental group) was treated with FT, and the other (control group) was treated with cefuroxime sodium. All stone specimens were collected via percutaneous nephrolithotomy (PCNL). The primary infection stones were screened via a stone component analysis, 30 cases in the experimental group and 31 cases in the control group. High-performance liquid chromatography (HPLC)-mass spectrometry was used to measure the drug concentration inside the stones, the bacterial count was calculated via stone culture, and the clinical infection index were monitored for between-group comparisons.

RESULTS

Compared with the control group, the experimental group had a higher internal drug concentration, a higher drug sensitivity against various pathogenic bacteria, a lower bacterial colony count in the stone culture, and a lower incidence of postoperative clinical infection.

CONCLUSIONS

FT is more effective than cefuroxime, which is commonly used during the perioperative period of urinary stones, and exerts a high antibacterial effect on these internal bacteria, and effectively reduces the probability of infection and sepsis after urinary stone surgery. FT can be used as an antibiotic during the perioperative period of urinary stones.

摘要

目的

本研究旨在评估磷霉素氨丁三醇(FT)对尿路感染结石内细菌的抗菌作用。

方法

通过扫描电子显微镜观察结石的内部结构,以验证内部细菌的存在。我们前瞻性地将符合纳入标准的肾结石患者随机分为两组,并在围手术期使用不同的抗生素进行治疗。一组(实验组)使用 FT 治疗,另一组(对照组)使用头孢呋辛钠治疗。所有结石标本均通过经皮肾镜碎石术(PCNL)采集。对原发性感染结石进行结石成分分析,实验组 30 例,对照组 31 例。采用高效液相色谱-质谱法(HPLC-MS)测量结石内药物浓度,通过结石培养计算细菌计数,并监测临床感染指标进行组间比较。

结果

与对照组相比,实验组的结石内药物浓度更高,对各种致病菌的药敏性更高,结石培养中的细菌菌落计数更低,术后临床感染发生率更低。

结论

FT 比围手术期常用的头孢呋辛更有效,对这些内部细菌具有较高的抗菌作用,有效降低了尿路结石手术后感染和脓毒症的发生概率。FT 可作为尿路结石围手术期的抗生素。

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