Wu J J, Chien M L, Lee N, Chou S F, Wang H M, Tsai W C
Department of Medical Technology, National Cheng Kung University Medical College, Tainan, Taiwan ROC.
J Formos Med Assoc. 1996 Jun;95(6):464-8.
Antimicrobial therapy can be a confounding factor in the diagnosis of urinary tract infection and is not always reported to laboratories by physicians. We developed a microbiologic assay for screening urine specimens for antimicrobial agents. Bacillus stearothermophilus was used as the indicator bacteria. A total of 1,921 urine specimens from three hospitals in Taiwan were screened using this assay. Of the samples assayed, 1,293 were positive for antimicrobial agents. Agreement between information provided by physicians and laboratory findings was 68.5% (419/612). In the presence of antimicrobial agents in the urine samples, the isolation of yeasts and Pseudomonas aeruginosa increased dramatically, from 4.5 to 19.5% and 4.2 to 13.2%, respectively. Additionally, Escherichia coli was more resistant to gentamicin (75.3% vs 48.7%, p < 0.0001), norfloxacin (85.2% vs 64.6%, p = 0.0006) and co-trimoxazole (58.5% vs 35.5%, p = 0.0018). In view of the high rate of occurrence of antimicrobial agents in urine specimens and the lack of information provided by most physicians to laboratories, a screening method to detect the presence (or absence) of antimicrobials in urine specimens may be a useful tool particularly in areas such as Taiwan where antimicrobial agents are commonly abused.
抗菌治疗可能是尿路感染诊断中的一个混杂因素，而且医生并不总是会向实验室报告这一情况。我们开发了一种微生物检测方法，用于筛查尿标本中的抗菌药物。嗜热脂肪芽孢杆菌用作指示菌。使用该检测方法对台湾三家医院的1921份尿标本进行了筛查。在所检测的样本中，1293份抗菌药物检测呈阳性。医生提供的信息与实验室检测结果之间的一致性为68.5%（419/612）。尿样中存在抗菌药物时，酵母菌和铜绿假单胞菌的分离率显著增加，分别从4.5%增至19.5%和从4.2%增至13.2%。此外，大肠埃希菌对庆大霉素（75.3%对48.7%，p<0.0001）、诺氟沙星（85.2%对64.6%，p=0.0006）和复方新诺明（58.5%对35.5%，p=0.0018）的耐药性更高。鉴于尿标本中抗菌药物的高发生率以及大多数医生未向实验室提供相关信息，检测尿标本中抗菌药物存在与否的筛查方法可能是一种有用的工具，特别是在台湾等抗菌药物普遍滥用的地区。
