Berger D, Boelke E, Seidelmann M, Beger H G
Department of General Surgery, University of Ulm, Germany.
Clin Chim Acta. 1996 Jan 31;244(2):155-61. doi: 10.1016/0009-8981(95)06190-8.
In 148 patients after major surgical procedures urinary endotoxin levels were determined and compared with bacteriological results. The study was designed as a screening study. Urine samples were collected once by suprapubic or transurethral catheters. In a first series of 49 patients urine bacteriology was positive (mainly, Gram-negative rods were found) in 3 cases. However, endotoxin determination was positive in these 3 patients and in a further 10 patients receiving antibiotic therapy for other reasons. Therefore, the following 99 patients were studied also by urinalysis by reagent strips for leukocytes and nitrite. In the second series, 12 urine cultures positive for bacteria were observed. Eleven samples were also endotoxin positive. Five more patients were endotoxin positive and had pathological but unspecific reagent strip results. These patients were treated with antibiotics for other reasons. Patients with candida found in the urine culture (n = 5) were endotoxin negative. Thus, endotoxin determination in urine obtained by suprapubic or transurethral catheters proved to be a very sensitive method for diagnosis of bacterial contamination, even during antibiotic treatment.
对148例接受大手术的患者测定尿内毒素水平，并与细菌学检查结果进行比较。本研究设计为一项筛查研究。通过耻骨上或经尿道导管一次性采集尿样。在第一组49例患者中，3例尿细菌学检查呈阳性（主要发现革兰氏阴性杆菌）。然而，这3例患者以及另外10例因其他原因接受抗生素治疗的患者内毒素测定呈阳性。因此，对接下来的99例患者也采用试剂条进行白细胞和亚硝酸盐的尿液分析研究。在第二组中，观察到12例尿培养细菌阳性。11份样本内毒素也呈阳性。另外5例患者内毒素呈阳性，试剂条检查结果为病理性但不具有特异性。这些患者因其他原因接受了抗生素治疗。尿培养中发现念珠菌的患者（n = 5）内毒素呈阴性。因此，通过耻骨上或经尿道导管采集的尿液进行内毒素测定被证明是诊断细菌污染的一种非常敏感的方法，即使在抗生素治疗期间也是如此。
