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[关于与感染相关的尿路结石的细菌学研究]

[A bacteriological study on urinary calculi associated with infections].

作者信息

Yoshida O, Kiriyama T, Okada K, Okada Y, Watanabe H, Mishina T, Uchida M, Watanabe K, Tomoyoshi T, Takayama H

出版信息

Hinyokika Kiyo. 1984 Feb;30(2):191-8.

PMID:6741755
Abstract

There are difficult problems in the management of urinary calculi associated with infections. Stones associated with infections are not only infection stones such as struvite stones, but also other kinds of stones such as calcium oxalate. Therefore, from practical view points, bacteriological studies should be carried out on urinary calculi associated with infections as a whole. We investigated 120 cases of urinary calculi associated with infections with special reference to bacteria on the stone surface, within the stone, compositions of the stone and permeation of an antibiotic into the stone. Proteus was isolated most frequently from the urine, followed by E. coli and Pseudomonas. These bacteria were isolated from the stone surface, although the incidence of Proteus mirabilis was higher than that in the urine. Bacteria were isolated in 25 of the 33 specimens of the inside parts and in 12 of the 12 stones of MAP and MAP plus other components. Proteus mirabilis was found in 7 of the 12 stones. Bacteria were isolated from the inside of 9 of the 16 stones of CaP and CaP plus other components and Proteus mirabilis was found in 6 of these 9 cases. Pseudomonas was isolated in 2 out of the 7 stones of CaP plus CaOX and its growth was seen in 5 specimens. The incorporation of an antibiotic, Cefmetazole, into the stone differed greatly with each stone. There were some cases in which the concentration of Cefmetazole in the inside was less than 5% of that in the outside. Stones may function as a sanctuary for organisms and may protect these organisms.

摘要

感染性尿路结石的管理存在难题。与感染相关的结石不仅包括感染性结石,如鸟粪石,还包括其他类型的结石,如草酸钙结石。因此,从实际角度出发,应对所有感染性尿路结石进行细菌学研究。我们对120例感染性尿路结石患者进行了调查,特别关注结石表面、结石内部的细菌、结石成分以及抗生素在结石中的渗透情况。变形杆菌最常从尿液中分离出来,其次是大肠杆菌和假单胞菌。这些细菌也从结石表面分离出来,尽管奇异变形杆菌在结石表面的发生率高于在尿液中的发生率。在33份结石内部标本中的25份以及12份鸟粪石和鸟粪石加其他成分的结石中的12份中分离出了细菌。在12份鸟粪石中的7份中发现了奇异变形杆菌。在16份磷酸钙结石和磷酸钙加其他成分的结石中的9份的内部分离出了细菌,其中9份中的6份发现了奇异变形杆菌。在7份磷酸钙加草酸钙结石中的2份中分离出了假单胞菌,并且在5份标本中观察到其生长。抗生素头孢美唑在结石中的掺入量因结石而异。在某些情况下,结石内部头孢美唑的浓度不到外部浓度的5%。结石可能充当微生物的庇护所并保护这些微生物。

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