Grifoni R, Pierangeli T
I.N.R.C.A., Istituto Geriatrico di Ancona.
Minerva Med. 1988 Jan;79(1):29-33.
Researches effected in different nations have revealed that 5-12% of all hospitalized patients was affected with a nosocomial infection and that almost 1/3 of these were urinary tract infections. The hospitalized urological patients have a considerable proneness to contract a nosocomial urinary tract infection, because they are subjected to transurethral or suprapubic bladder catheterisms, to transurethral surgery and to the endoscopies, that are promoting maneuvers the urinary tract infections. Generally the Gram negative bacilli are the cause of hospital-acquired urinary tract infections, even if lately Gram positive bacilli (especially Streptococcus Faecalis or Enterococcus), "Gram negative Facultative pathogens" (Klebsiella, Providencia, Citrobacter, Serratia) and Fungi are very important. Considering the importance of these infections we have examined the incidence of the urinary tract infections of the hospitalized patients between January 1, 1986 and December 31, 1986 in our Urologic Institute. During the 12-month study interval there were 450 hospital admissions, and 45 patients were affected with a nosocomial urinary tract infection (10%). The females were affected at the rate of 6.7% of them, with an incidence of 4.7% among all patients with a positive urine culture; on the contrary the males were affected at the rate of 11.4% of them, equal to 19.0% of patients with a positive urine culture. We have noticed that among the responsible microorganisms for the nosocomial urinary tract infections, the group of the "Gram negative Facultative pathogens" was more frequent (40%), followed by Pseudomonas Aeruginosa and Candida species. So also in our Urologic Institute the modification of the responsible agents for the nosocomial urinary tract infections happened. The nosocomial infections after the discovery of the antibiotics were considered wiped out, on the contrary these infections are still an important problem of public health, so that efficaciously must be tackled.
不同国家的研究表明，所有住院患者中有5%-12%受到医院感染，其中近三分之一为尿路感染。住院的泌尿科患者极易感染医院获得性尿路感染，因为他们要接受经尿道或耻骨上膀胱插管、经尿道手术和内窥镜检查，这些操作会增加尿路感染的几率。一般来说，革兰氏阴性杆菌是医院获得性尿路感染的病因，不过近来革兰氏阳性杆菌（尤其是粪链球菌或肠球菌）、“革兰氏阴性兼性病原菌”（克雷伯菌属、普罗威登斯菌属、柠檬酸杆菌属、沙雷菌属）和真菌也非常重要。鉴于这些感染的重要性，我们对1986年1月1日至1986年12月31日期间我院泌尿科住院患者的尿路感染发生率进行了调查。在为期12个月的研究期间，共有450例住院患者，其中45例受到医院获得性尿路感染（10%）。女性患者的感染率为6.7%，在所有尿培养阳性患者中的发生率为4.7%；相反，男性患者的感染率为11.4%，占尿培养阳性患者的19.0%。我们注意到，在医院获得性尿路感染的致病微生物中，“革兰氏阴性兼性病原菌”组更为常见（40%），其次是铜绿假单胞菌和念珠菌属。因此，在我院泌尿科，医院获得性尿路感染的致病原也发生了变化。抗生素发现后，医院感染曾被认为已被消除，相反，这些感染仍然是一个重要的公共卫生问题，因此必须有效应对。
