Tan Jiaying, Tian Mi, Zhao Feng, Deng Shuixiang, Jin Peng, Wang Yao, Wen Huimei, Qin Xiaohua, Gong Ye
Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China.
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China.
Infect Drug Resist. 2021 May 14;14:1795-1803. doi: 10.2147/IDR.S298250. eCollection 2021.
Male genitourinary abscess is one of the serious complications of urinary tract infections (UTIs). There were few researches on the clinical and pathogenic characteristics of male genitourinary abscess.
A retrospective observational study was conducted between January 2004 and April 2019. Male patients with genitourinary abscess originated from urinary tract, including sites of scrotum, testis, epididymis, spermatic cord, and prostate, were enrolled. Clinical and microbial records were collected and analyzed, and antimicrobial susceptibility testings were performed according to CLSI standard. Whole-genome sequencing was applied to detect the β-lactamase genes and virulence genes, as well as to determine the multilocus-sequence typing (MLST) of the collected () isolates.
A total of 22 male patients were included. The main clinical symptoms were fever (86.4%), scrotal swelling (68.2%), local skin warmth (59.1%) and ulceration (45.5%). Urinary irritation was often presented in prostate involved abscess. Ultrasound features had a 94.7% positive rate. Surgical treatment, including abscess drainage, was helpful to the prognosis. No matter where the specimens obtained from, including blood, urine or pus, multidrug-resistant was the dominant (11 cases, 50.0%) microorganism in positive cultures. Nine of eleven isolates had been preserved and recovered. As for MLST typing, all the nine available isolates of belonged to the ST11 type and characterized with carbapenemase gene. Virulence genes , aerobactin genes ( and ) and type 3 fimbriae genes () were identified in all the isolates.
It seemed that more patients under 35 years old were vulnerable to genitourinary abscess. There was an increasing trend that multidrug-resistant isolates with multiple virulence genes were involved in male genitourinary abscess. Prompt and proper antibiotic use, combined with adequate drainage of the abscess, was important to prognosis.
男性泌尿生殖系统脓肿是尿路感染（UTIs）的严重并发症之一。关于男性泌尿生殖系统脓肿的临床和致病特征的研究较少。
进行了一项回顾性观察研究，时间跨度为2004年1月至2019年4月。纳入起源于泌尿系统的男性泌尿生殖系统脓肿患者，包括阴囊、睾丸、附睾、精索和前列腺部位。收集并分析临床和微生物学记录，并根据CLSI标准进行药敏试验。应用全基因组测序检测β-内酰胺酶基因和毒力基因，并确定所收集的（）分离株的多位点序列分型（MLST）。
共纳入22例男性患者。主要临床症状为发热（86.4%）、阴囊肿胀（68.2%）、局部皮肤发热（59.1%）和溃疡（45.5%）。前列腺受累脓肿常出现尿路刺激症状。超声特征阳性率为94.7%。手术治疗，包括脓肿引流，对预后有帮助。无论从血液、尿液还是脓液中获取标本，多重耐药（）是阳性培养物中的主要微生物（11例，50.0%）。11株（）分离株中有9株已保存并复苏。至于MLST分型，所有9株可用的（）分离株均属于ST11型，并具有（）碳青霉烯酶基因特征。在所有（）分离株中均鉴定出毒力基因（）、气杆菌素基因（和）和3型菌毛基因（）。
似乎35岁以下的患者更容易患泌尿生殖系统脓肿。多重耐药且具有多个毒力基因的（）分离株参与男性泌尿生殖系统脓肿的情况呈上升趋势。及时、合理使用抗生素，结合脓肿的充分引流，对预后很重要。
