益生菌对儿童导尿管相关尿路感染的预防作用探究

Exploration of the preventive effect of probiotics on catheter-related urinary tract infections in children

目的:探究益生菌对儿童导尿管相关尿路感染的预防作用。方法:选取2019年12月—2020年10月苏州大学附属儿童医院泌尿外科收治的100例需长时间(约10 d)留置导尿管的泌尿系统疾病患儿作为研究对象,按照随机数表法将其随机分为试验组和对照组,每组50例。对照组患儿留置导尿管后,给予抗生素抗感染等常规治疗;试验组患儿留置导尿管后,在常规治疗的基础上,加服酪酸梭菌二联活菌散剂。比较两组患儿导尿管相关尿路感染(CAUTIs)发生情况、拔除导尿管时尿液及导尿管病原菌培养情况。结果:两组患儿均于术后第10天拔除导尿管。试验组患儿CAUTIs发生率、拔除导尿管时尿常规感染指标与对照组比较,差异无统计学意义(P>0.05),但试验组导尿管培养阳性率以及菌群>100 cfu比例均显著低于对照组(P<0.05),且两组患儿导尿管培养阳性率均明显高于尿液培养阳性率(P<0.05),感染病原菌均以革兰阳性菌为主。结论:益生菌可明显减少导尿管管壁上细菌群落的定植,在一定程度上预防CAUTIs的发生。

Objective Explore the preventive effect of oral probiotics on catheter-related urinary tract infections in children.Methods A total of 100 children with long-term catheterization were selected as the study objects in the Department of Urology,Children's Hospital of Soochow University during the period from December 2019 to October 2020.Patients were randomly divided into the experimental group and the control group,50 each.In the experimental group,take probiotics(Combined Clostridium Butyrium and Bifidobacterium Powders,live)at the dosage specified in the instructions in addition to conventional treatment.In the control group,only conventional treatment was given.The infection rate of CAUTIs and the results of laboratory examination in different periods were compared between the two groups.Results The catheters were removed on the 10 th day after operation in both groups.The incidence of CAUTIs in the experimental group was lower than that in the control group,but there was no statistical difference(P>0.05).The positive rate of catheter culture was lower than that in the control group,but there was no statistical difference.The proportion of bacterial flora>100 cfu in the two groups was significantly lower than that in the control group(all P<0.05),and the positive rate of catheter culture in the two groups was significantly higher than that of urine culture(P<0.05).The pathogenic bacteria were mainly Gram-positive bacteria.Conclusions Probiotics can significantly reduce the colonization of bacterial communities on the wall of urinary catheters,indicating that oral administration of probiotics in pediatric patients with indwelling catheters can to some extent prevent the occurrence of urinary tract infections related to catheters.