Guibert J
Consultation de pathologie infectieuse, hôpital Saint-Joseph, Paris.
Rev Prat. 1993 May 1;43(9):1081-5.
Cytobacteriological examination of urine is indispensable in patients with acute or chronic pyelonephritis. Direct examination through the microscope is fundamental in acute pyelonephritis where immediate antibiotic therapy is mandatory. A significant bacteriuria points to an obstacle to urine flow. Escherichia coli is the most common pathogen in acute and chronic pyelonephritis. Isolating a Proteux strain suggests that lithiasis is present. Pseudomonas aeruginosa always has a nosocomial origin and is often responsible for chronic asymptomatic pyelonephritis. Staphylococci and enterococci may produce pyelonephritis, notably when it is associated with urinary stones. Since hospital- or community-acquired strains of E. Coli are strongly resistant to aminopenicillins and cotrimoxazole, these antibacterials must not be used as first-line treatment of pyelonephritis.
对于急性或慢性肾盂肾炎患者，尿液的细胞细菌学检查必不可少。在急性肾盂肾炎中，显微镜直接检查至关重要，因为必须立即进行抗生素治疗。显著菌尿表明存在尿液流动障碍。大肠杆菌是急性和慢性肾盂肾炎中最常见的病原体。分离出变形杆菌菌株提示存在结石。铜绿假单胞菌总是源于医院感染，常导致慢性无症状肾盂肾炎。葡萄球菌和肠球菌可能引发肾盂肾炎，尤其是与尿路结石相关时。由于医院获得性或社区获得性大肠杆菌菌株对氨基青霉素和复方新诺明具有很强的耐药性，因此这些抗菌药物不得用作肾盂肾炎的一线治疗药物。
