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[结石性肾盂肾炎患者的直接细菌学研究]

[Direct bacteriological studies of patients with calculous pyelonephritis].

作者信息

Anastasov G, Todorova L, Panchev P, Raĭchev G

出版信息

Vutr Boles. 1985;24(6):94-100.

PMID:4095985
Abstract

The authors report their observations on the bacteriological studies in 115 patients with chronic calculous pyelonephritis. Intraoperatively, pelvic urine and biopsic material was taken from the pyelonephritis changed areas of the kidney and directly inoculated upon enriched nutrient medium "Difco" Later, inoculations were carried out on solid nutrient media. A total of 225 bacteria of 8 species were isolated. Bacteria were present in pelvic urine or in kidney punched-out material of all patients with calculous pyelonephritis, often--in both places. In 52.2% of the cases the bacteria established in both the places were identical, and in the rest of the cases--different or association of the same with another bacterium. An attempt was made to explain that phenomenon. E. coli, Pr. mirabilis and Staph. aureus were most frequently isolated. Consideration given to the observations, the authors recommend active uroantiseptic therapy in case of clinic of exacerbated chronic calculous pyelonephritis evan in case of sterile urine, as well as not very strict observation of the requirements of antibiogram with bacteriuria established. The experience of the inclusion of antistaphylococcal treatment is indicated in case of a picture of urosepsis in patients with chronic calculous pyelonephritis even in the absence of the isolated Staph. aureus from urine.

摘要

作者报告了他们对115例慢性结石性肾盂肾炎患者进行细菌学研究的观察结果。术中,从肾盂肾炎病变的肾脏区域获取肾盂尿液和活检材料,并直接接种于“Difco”富集营养培养基上。之后,在固体营养培养基上进行接种。共分离出8种225株细菌。在所有结石性肾盂肾炎患者的肾盂尿液或肾脏活检材料中均发现有细菌,且往往两处都有。在52.2%的病例中,两处发现的细菌相同,其余病例中细菌不同或相同细菌与另一种细菌混合存在。作者试图解释这一现象。最常分离出的细菌为大肠杆菌、奇异变形杆菌和金黄色葡萄球菌。考虑到这些观察结果,作者建议,对于慢性结石性肾盂肾炎急性发作的患者,即使尿液无菌,也应积极进行尿路抗菌治疗,对于已确诊菌尿的患者,对抗生素敏感性试验结果的要求不必过于严格。对于慢性结石性肾盂肾炎患者出现尿脓毒症的情况,即使未从尿液中分离出金黄色葡萄球菌,也表明有采用抗葡萄球菌治疗的经验。

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