凝固酶阴性葡萄球菌检测在慢性前列腺炎中的意义

Significance of coagulase-negative staphylococci in chronic prostatitis

目的 研究慢性前列腺炎与凝固酶阴性葡萄球菌 (CNS)的关系 ,探讨前列腺液中CNS检测的临床意义。 方法 对 4 2 8例慢性前列腺炎患者采用Meares Stamey四段取样法作前列腺液细菌培养和药敏试验。患者年龄 18～ 4 6岁 ,平均 31岁。病程 3～ 32个月 ,平均 6个月。慢性前列腺炎症状指数 (NIH CPSI)平均 2 3.2分。 结果 4 2 8例均行细菌培养 ,其中 2 4 8例 (5 7.94 % )分离出细菌。革兰阳性菌 195例 (78.6 3% ) ,其中葡萄球菌 16 0例 (6 4 .5 2 % ,16 0 / 2 4 8) ,CNS 89例 (35 .89% ,89/ 2 4 8) ;CNS中以表皮葡萄球菌为主者 81例 (32 .6 6 % ) ,其次为腐生葡萄球菌 3例和溶血性葡萄球菌 2例 ;NIH CPSI积分与细菌培养结果无明显相关。CNS对常用抗菌药物 (β 内酰胺类、喹诺酮类、氨基糖苷类 )耐药率较高 (5 1.9%～ 10 0 % )。 结论 CNS为慢性前列腺炎的主要致病菌 ,应引起高度重视 ;适时监测前列腺液病原菌及药敏试验对临床诊断和治疗慢性前列腺炎具有重要意义。

Objective To investigate the relationship between chronic prostatitis and the coagulase-negative staphylococci (CNS),and to study the diagnostic value and clinical significance of CNS in expressed prostatic secretion (EPS). Methods Overall,428 patients with chronic prostatitis were included in this study.Their mean age was 31 years (range,18 to 46 years).The mean cause was 6 months (range,3 to 32 months).The mean NIH-CPSI score was 23.2.Bacterial culture and antimicrobial agent sensitivity test were applied to samples from the 428 patients.The samples were taken with 4 tubes from the lower urinary tract segmented by Meares-Stamey method. Results Bacteria were found in 248 patients (57.94%) out of 428 ones.Gram-positive bacteria were found in 195 cases(78.63%).In the 195 cases,staphylococci were found in 160 cases(64.25%,160/248).CNS were found in 89 cases(35.89%,89/248),most of which were epidermidis staphylococci 81 cases(32.66%).The next were saprophytic staphylococci 3 cases and hemolytic staphylococci 2 cases.There was no correlation between NIH-CPSI score and bacterial culture results.The sensitivity test results showed the rate of drug resistance of CNS from EPS was high for β-lactamases,quinolones and aminoglycosides(51.9% to 100%). Conclusions The results suggest that CNS is a main kind of pathogen of chronic prostatitis,so considerable attention should be paid to it.In addition,it is of significant importance to apply bacterial culture and sensitivity test in EPS to the diagnosis and treatment of chronic prostatitis.