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一项关于菌尿症与膀胱镜检查之间关联的病例对照研究。

A Case-Control Study on the Association between Bacteriuria and Cystoscopy.

作者信息

Yeung Eugene Y H

机构信息

Department of Medical Microbiology, The Ottawa Hospital General Campus, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.

出版信息

Infect Dis Rep. 2021 Mar 1;13(1):205-214. doi: 10.3390/idr13010023.

Abstract

To date, there is only one published report of an outbreak of urinary tract infections by species after cystoscopy. Disinfection procedures for cystoscope have come into question. The current study aimed to determine the odds of developing bacteriuria after cystoscopy. A retrospective case-control study was conducted on all patients with species in urine (case) and blood (control) from 2017 to 2019 in 16 hospitals in Eastern Ontario, Canada. Eight of the 11 patients had cystoscopy prior to bacteriuria; three of the 74 patients had urological procedures prior to bacteremia, but none of their procedures were cystoscopy. The odds ratio of urological procedures with bacteriuria was 63.1 (95% CI 10.9 to 366.6; < 0.0001). In the bacteriuria group, the most frequently identified isolates were (n = 8), followed by , and . Seven of the isolates had identical susceptibilities (ampicillin-sensitive; sulfamethoxazole/trimethoprim-sensitive; ciprofloxacin intermediate). In the bacteremia group, the most frequently identified isolates were (n = 22), followed by , , , and . The result suggested cystoscopy is a risk factor for bacteriuria. Identification of bacteriuria should prompt public health investigations of linkage between cystoscopy and bacteriuria.

摘要

迄今为止,仅有一篇关于膀胱镜检查后特定菌种引起尿路感染暴发的报道。膀胱镜的消毒程序因此受到质疑。本研究旨在确定膀胱镜检查后发生特定菌尿的几率。对2017年至2019年加拿大安大略省东部16家医院所有尿液(病例组)和血液(对照组)中存在特定菌种的患者进行了一项回顾性病例对照研究。11例患者中有8例在发生菌尿之前进行了膀胱镜检查;74例患者中有3例在发生菌血症之前进行了泌尿外科手术,但他们的手术均不是膀胱镜检查。发生特定菌尿的泌尿外科手术的比值比为63.1(95%可信区间10.9至366.6;P<0.0001)。在菌尿组中,最常鉴定出的分离株是特定菌种(n = 8),其次是其他菌种。特定菌种的分离株中有7株具有相同的药敏性(对氨苄青霉素敏感;对磺胺甲恶唑/甲氧苄啶敏感;对环丙沙星中介)。在菌血症组中,最常鉴定出的分离株是特定菌种(n = 22),其次是其他菌种。结果表明膀胱镜检查是发生特定菌尿的一个危险因素。特定菌尿的鉴定应促使对膀胱镜检查与特定菌尿之间的关联进行公共卫生调查。

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Outbreak of urinary tract infections by Salmonella spp. after cystoscopic manipulation.
Actas Urol Esp. 2016 Dec;40(10):646-649. doi: 10.1016/j.acuro.2016.02.005. Epub 2016 Apr 6.

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