Daifuku R, Stamm W E
JAMA. 1984 Oct 19;252(15):2028-30.
To assess the role of antecedent rectal and urethral colonization in the pathogenesis of catheter-associated urinary tract infections, we prospectively studied 64 patients, obtaining urine, rectal, and urethral cultures on study entry, two days later, and every four days thereafter. Of 55 patients who remained catheterized for at least three days, urethral colonization with the same microorganism present in bladder urine was observed in the sampling period preceding the onset of bacteriuria in 12 of 18 infections in women and five of 17 in men. Rectal colonization with the infecting strain preceded bacteriuria in 14 of 18 infections in women and five of 17 in men. The identity of the urinary, urethral, and rectal isolates was confirmed by speciation, serotyping, antibiograms, and biotyping. We conclude that rectal and periurethral colonization often precedes catheter-associated bacteriuria, especially in women, and that effective preventive measures aimed at transurethral infection should be developed.
为评估先前直肠和尿道定植在导尿管相关性尿路感染发病机制中的作用，我们对64例患者进行了前瞻性研究，在研究开始时、两天后以及此后每四天采集尿液、直肠和尿道培养物。在55例留置导尿管至少三天的患者中，在女性18例感染中有12例、男性17例感染中有5例的菌尿症发作前的采样期内，观察到尿道定植有与膀胱尿液中相同的微生物。在女性18例感染中有14例、男性17例感染中有5例的感染菌株直肠定植先于菌尿症。通过菌种鉴定、血清分型、抗菌谱和生物分型确认了尿液、尿道和直肠分离株的一致性。我们得出结论，直肠和尿道周围定植通常先于导尿管相关性菌尿症，尤其是在女性中，应制定针对经尿道感染的有效预防措施。
