Olling S, Jones K V, Mackenzie R, Jones E R, Hanson L A, Asscher A W
Clin Nephrol. 1981 Oct;16(4):169-71.
In 75 schoolgirls aged 5-11 with untreated covert coliform bacteriuria who were followed up to 4 years, infection cleared in 16 (21%), cleared and recurred in 37 (50%) and persisted in 22 (29%). Clearance of bacteriuria was significantly (P less than .05) more frequent in girls with normal radiological findings than in those with abnormal findings. In 31 (59%) of the 53 girls in whom bacteriuria cleared spontaneously, the urine became sterile within the first year after the discovery of the bacteriuria. Spontaneous clearance of bacteriuria was preceded by an increase of the sensitivity of the urinary pathogens to the cidal effect of human serum. Seven (10%) of the 75 untreated bacteriuric girls had shown progression of kidney damage (progression of scarring in 4 and failure of kidney growth in 3). In all of these 7 girls vesico-ureteric reflux (VUR) was present and bacteriuria was persistent, but in 6 of them from one to three changes in the serotype of Esch. coli or bacterial species were noted during follow-up. These observations suggest that changes in bacterial flora may be a risk factor in the progression of kidney damage in girls with urinary tract infection and VUR.
对75名年龄在5至11岁、未经治疗的隐匿性大肠埃希菌菌尿症女学生进行了长达4年的随访，其中16名（21%）感染清除，37名（50%）清除后复发，22名（29%）持续存在菌尿。放射学检查结果正常的女孩菌尿清除率显著高于（P<0.05）检查结果异常的女孩。在53名菌尿自行清除的女孩中，有31名（59%）在菌尿被发现后的第一年内尿液转为无菌。菌尿自行清除之前，尿路病原体对人血清杀菌作用的敏感性有所增加。75名未经治疗的菌尿症女孩中有7名（10%）出现了肾脏损害进展（4名瘢痕形成进展，3名肾脏生长停滞）。所有这7名女孩均存在膀胱输尿管反流（VUR）且菌尿持续存在，但其中6名在随访期间大肠埃希菌血清型或细菌种类发生了一至三次变化。这些观察结果表明，细菌菌群的变化可能是患有尿路感染和VUR的女孩肾脏损害进展的一个危险因素。
