Asymptomatic bacteriuria among hospitalized diabetic patients:Should they be treated?

Diabetes Mellitus is a significant health care challenge in the United States.The Center for Disease Control and Prevention estimates approximately 9.4%of patients in the United States are afflicted by diabetes.The Infectious Disease Society of America asymptomatic bacteriuria in women as two consecutive cleancatch voided urine specimens with isolation of the same bacterial strain in counts≥105 cfu/mL It is understood that diabetic patients tend to be at higher risk for infections than non-diabetics.Urinary tract infections(UTIs)tend to be the most common infection contracted by this population.UTIs are not only a significant cause of morbidity and mortality,they are also a significant financial burden.The data are conflicting,in regard to treating asymptomatic bacteriuria in diabetic patients to avoid hospital complications and ultimately decrease healthcare costs associated with these complications.However,clinicians continue to prescribe antibiotics empirically.Further randomized controlled study looking into the specific population as immunocompromised diabetic patients,patient with diabetic ketoacidosis and patient in intensive care unit needs to be undertaken.

Asymptomatic bacteriuria in pregnancy in Port Harcourt

Objective:To determine the prevalence of asymptomatic bacteriuria in pregnancy,to consider the antimicrobial sensitivity patterns of involved uropathogens,to elucidate the safety profiles of antibacterial agents,and to evaluate the role of urinalysis in screening for asymptomatic bacteriuria.Methods:About 760 apparently healthy pregnant subjects attending the Antenatal Clinic of the University of Port Harcourt Teaching Hospital were randomly selected for this study.Urinalysis and microscopy,culture,and sensitivity tests were carried out on clean-catch midstream urine samples obtained from subjects.Biochemical reagent strips were used for urinalysis while the standard wire loop and agar diffusion technique were respectively employed for culture and susceptibility testing.Results:A total of 111 samples yielded moderate or severe growth on culture after 48 hours comprising 35,31,27,and 18 isolates of Staphylococcus spp.,Proteus spp.,Klebsiella spp.,and Escherichia spp,respectivehy.Urinalysis results were positive for the presence of nitrate reductase and leucocyte esterase activity in 17 urine samples of these 111 samples.The isolates showed a general sensitivity to the fluorinated quinolones and to Nitrofurantoin.Conclusions:The prevalence of asymptomatic bacteriuria is 14.6%, with the predominant organism being Staphylococcus spp.Drugs used for treatment should have excellent fetal safety profiles,and a rapid screening test with a high negative predictive value for asymptomatic bacteriuria would be ideal.

Asymptomatic Bacteriuria and Urinary Tract Infection in Pregnant Women with and without Diabetes Mellitus and Gestational Diabetes Mellitus—A Case-Control Study

Background: Asymptomatic bacteriuria (ASB) and urinary tract infections (UTI) during pregnancy may contribute to adverse pregnancy outcomes. Diabetes mellitus (DM) and gestational diabetes mellitus (GDM) are considered to be important additional risk factor for ASB and UTI during pregnancy. Aims: To investigate differences in prevalence of ASB and incidence of UTI in pregnant women with and without DM and GDM to inform ASB screening and treatment policies. Methods: Data from 214 pregnant women who gave birth during 2010 at the Women’s and Children’s Hospital, Adelaide, Australia where cases were women with a clinical diagnosis of (G)DM and controls were matched on date of birth. ASB was defined as the growth of at least 10e5 colony forming units/ml of one organism or any presence of group B streptococcus (GBS) at the first urine culture collected during pregnancy without complaints of a UTI. A clinical UTI was diagnosed by the treating physician, in combination with a positive urine culture it was defined as culture-confirmed UTI. Results: No significant differences in prevalence of ASB (5.6% and 3.7%;relative risk (RR) 1.50;95% confidence intervals (CI) 0.44 - 5.17), incidence of clinical UTI (4.7% and 11.2%;RR 0.42;95% CI 0.15 - 1.14) or culture-confirmed UTI (2.8% and 3.7%;RR 0.75;95% CI 0.17 - 3.27) between pregnant women with and without (G)DM were present. No association was found between ASB and UTI. GBS was the most common causative organism of ASB in women with and without DM (66.7% and 50.0%). Conclusion: In contrast with earlier research, no significant differences in prevalence of ASB or incidence of UTI was found between pregnant women with and without (G)DM.

Correlation between Asymptomatic Bacteriuria and HIV-1 Viral Load Level and CD4 Count in Pregnant Women on Antiretroviral Therapy in N’djamena (Chad)

A cross-sectional study was conducted at the “Centre de l’Appui Psycho-Médico-Social (APMS)” which is a centre for Psychological and Medical Support in N'Djamena (Chad) from January to March 2014. The aim of this study was to evaluate the correlation between asymptomatic bacteriuria (ASB) and viral load level and CD4 count in seventy-six (76) HIV-1 infected pregnant women on antiretroviral therapy (ART). Urine culture and bacteria identification were performed by using a chromogenic culture medium (UriselectR4). T CD4+ lymphocytes count and viral load measurement were done respectively on PIMATM test and Abbott m2000 RealTime HIV-1. In this study, 25 (32.9%) pregnant women were carrying ASB and major bacteria;Escherichia coli and Streptococcus agalactiae known to cause neonatal meningitis to newborns were identified. Bacteria were isolated mainly in women with CD4 lymphocytes 3log (70%) (19/25). Besides the prevention of mother to child transmission of HIV, which remains a goal, it is important to prevent also the transmission of other microorganisms causing neonatal infections. Our findings support the needs to do bacteriological analysis of urine in every HIV-infected pregnant woman at least in late pregnancy.

Which Patients Should be Administrated Prophylactic Antibacterial Agents? A Study of Bacteriuria or Funguria by Urine Culture Taken From the Renal Pelvis in Children with Ureteropelvic Junction Obstruction

Objective: To detect bacteriuria or funguria by urine culture taken from the renal pelvis directly before Anderson-Hynes pyeloplasty. Methods: 290 patients who underwent Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction (UPJO) were included in a retrospective analysis. Urine was obtained directly before the renal pelvis was opened, and was carried to the laboratory for bacterial culture. Clinical features were analyzed to evaluate risk factors for bacteriuria or funguria by comparing patients whose urine yielded positive cultures to those whose urine cultures were negative for bacteria or yeast. Results: Eighteen patients (6.2%) had positive urine cultures, including six cultures positive for Escherichia coli (E. coli), four for Pseudomonas aeruginosa, three for klebsiella pneumoniae, one for maltophilia monad, one for Enterococcus faecium, one for Candida albicans, one for Candida parapsilosis, and one for yeast not otherwise specified. Bacteriuria or funguria was significantly correlated with four clinical features: fever, urinary urgency, and history of nephrostomy or pyeloplasty. Conclusions: Bacteriuria or funguria was less common in children with UPJO, and the majority of organisms were identified as Escherichia coli, Pseudomonas aeruginosa, or Klebsiella pneumoniae. Prophylactic antibacterial agents were probably necessary in those patients who had signs of urinary tract infection (UTI), or history of nephrostomy or pyeloplasty.

Asymptomatic Bacteriuria in Pregnant Women in the Antenatal Booking Clinic at Aminu Kano Teaching Hospital, Kano, Nigeria

Asymptomatic bacteriuria is common in pregnant women and if untreated could lead to serious complications. Despite this, its prevalence and microbiological characteristics have not been well studied in Kano and they vary among different populations. The objective of the study was to determine the prevalence, microbiological characteristics and pregnancy outcome of asymptomatic bacteriuria in pregnancy among women who came for antenatal booking clinic at the Aminu Kano Teaching Hospital (AKTH) Kano. A cross sectional descriptive study was conducted among randomly selected 200 consenting pregnant women who came for antenatal booking from November 2010 to January 2011. Samples of 10 - 15 mls urine were examined for pus cells and bacteria and then cultured on cysteine lactose electrolyte deficient agar. Colony counts yielding bacterial growth of 105/ml or more of pure isolates were deemed significant. Isolates were identified to specie level. Antibiotic sensitivity test was done, treatment was given and pregnancy outcome was determined. Urinalysis and Full Blood Count were done. The prevalence of asymptomatic bacteriuria in pregnancy was 9%. Parity and Pyuria had statistically significant association with asymptomatic bacteriuria (P < 0.05). The commonest organisms isolated wereKlebsiella?spp. and?Staphylococcus saprophyticus. Following treatment of asymptomatic bacteriuria, there was no statistically significant difference in pregnancy outcome compared to patients who did not have the condition. The incidence of asymptomatic bacteriuria in pregnancy in AKTH is low. Screening of pregnant women using urine microscopy culture and sensitivity should be reserved for pregnant women with higher risk of developing asymptomatic bacteriuria.

Prevalence of Asymptomatic Bacteriuria in HIV Infected Patients in a Tertiary Hospital in Lagos, Nigeria

Background: People living with Human Immunodeficiency Virus (HIV) are more predisposed to urinary tract infections due to suppression of their immunity by the virus. Asymptomatic bacteriuria is associated with an increased risk of symptomatic urinary tract infection and the latter being an important contributor to development of chronic renal failure, hypertension and toxaemia of pregnancy. The aim of this study was to determine the prevalence of asymptomatic bacteriuria in HIV-infected patients and proffer a recommendation on the need or otherwise to screen. Methods: This was a cross sectional study of treatment-naive HIV-infected patients attending the HIV clinics of Lagos State University Teaching Hospital (LASUTH), Ikeja. A single voided aseptically collected mid-stream urine (MSU) was obtained from each patient and all samples processed immediately, were sent for urinalysis and culture. Isolates were considered significant if there were ≥105 colony forming unit/mL (CFU/mL) with 2 or less isolates, doubtful significance if 5 CFU/mL. Significant isolates were selected for identification. Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). Results: A total of 156 consenting participants were recruited into the study. The mean age was 36.45 ± 8.65 years. There were 60 of 156 (38.4%) males and 96 of 156 (61.56%) females. Only 33 of 156 (21.2%) had significant bacteriuria, out of the 33 participants, 19 (57.8%) were asymptomatic, while 14 of 33 (42.4%) had significant growth but were symptomatic or on antibiotics. E. coli was isolated in 9 of 19 (47.3%), followed by Staph aureus 4 of 19 (21.05%). Conclusion: More than half of participants who had significant growth had asymptomatic bacteriuria, while one-fifth of all patients had significant growth. Considering this statistics, screening for or treatment of asymptomatic bacteriuria may be recommended in all HIV-infected patients.

Is There Any Relationship between Maternal Vitamin D Levels and Asymptomatic Bacteriuria? A Preliminary Study

Hypothesis: Vitamin D has been considered to play important roles in maintaining pregnancy. Also, this vitamin is considered to regulate immune response and thus may be important for pregnant women also to maintain no-infection of which preterm delivery is especially important. Since vitamin D regulates maternal anti-infection function and since Asymptomatic bacteriuria (ASB) causes various adverse outcomes in pregnancy, we hypothesized that maternal serum vitamin D level may be related with the presence/absence of ASB. The present study was an effort to determine this. The study included 215 pregnant women, attended the Ondokuz Mayis University Hospital antenatal care polyclinic, Samsun, Turkey, in the summer for initial visits between 6- and 14-weeks’ gestation. Women with symptoms suggestive of urinary tract infection, a history of antibiotic use within the previous two weeks, ongoing antibiotic therapy or urinary system instrumentation, a diagnosis of vitamin D insufficiency or deficiency, and those taking vitamin D supplements were excluded. Demographic data features of the sampled women were analyzed retrospectively. 10 ml maternal peripheral venous blood samples were collected and the concentrations of 25(OH)D3 in the serum were analyzed. Mid-stream morning urine samples were obtained and analyzed at the microbiology laboratory according to established procedures. ASB was reported if bacteria were present at specified quantitative counts (≥105 CFU/ml) in the urine without any sign or symptom. Participants were divided into two groups: ASB (-)—participants without ASB (n = 200) and: ASB (+)—participants with ASB (n = 15). There was no statistically significant relationship between the two groups in terms of demographic features. There was no statistically significant relationship between the distribution of maternal 25(OH)D3 levels in the two groups (p > 0.05). The comparison of maternal median 25(OH)D3 levels between the two groups showed no statistically significant difference (p = 0.576). No statistically significant correlation was found between 25(OH)D3 levels and age, gravida, parity, body weight, or gestation week (p > 0.05). Although there was no significant relationship between maternal vitamin D levels and ASB in this research, further studies in larger groups will increasingly highlight and clarify this topic.

Antimicrobial Susceptibility Pattern of Bacteriuria and Risks of Therapeutic Failure among Pregnant Women in Primary Health Care of Macao, China

Both asymptomatic (ASB) and symptomatic bacteriuria during pregnancy increase the risk of adverse fetal or maternal outcomes. Our study aims to determine the prevalence of bacteriuria, the etiological agents with their susceptibility to antimicrobials, and the risk factors for therapeutic failure among pregnant women for antenatal care in the primary health care of Macao, China. Methods: This is a cross-sectional survey involving 5101 antenatal care pregnant women from 1st Jan to 31st Dec., 2017. The mid-stream clean-catch urine specimens were routinely examined microscopically and cultured following the first consultation. Other data were collected from the computerized medical records. Results: The mean age of the pregnant women was 31.4 ± 5.04 years. We followed 130 women with positive cultures on first consultation, of whom 35 (26.9%) were found to have contaminated cultures. 95 pregnant women were confirmed to have UTI. The prevalence of bacteriuria was 1.86% (n = 95), of which 83 (87.4%) were asymptomatic. ASB was mainly in the younger age-group (20 - 30 years) and the primipara. Of 196 positive cultures, the commonest bacterium was Escherichia coli (n = 111 or 56.6%, 98.2% susceptible to nitrofurantoin), followed by Klebsiella pneumonia (n = 20 or 10.2%, 90% susceptible to 2nd generation cephalosporin), and Streptococcus agalactiae (n = 16 or 8.2%, 100% susceptible to nitrofurantoin). After treatment, there were 80 (84.2%) therapeutic successes and 15 (15.8%) failures. Symptomatic infection and later trimester were significantly associated with therapeutic failure (P ≤ 0.05). Conclusions: ASB is common in the young age group and primipara. Nitrofuranton and 2nd generation cephalosporin are effective antibiotics against UTI in pregnancy. Symptomatic infection and occurrence in later trimester were significantly associated with treatment failure.

中国肾脏移植受者尿路感染临床诊疗指南

尿路感染是肾脏移植术后最常见的感染性并发症。为了进一步降低肾脏移植术后受者尿路感染的发生率,提高中国肾脏移植术后受者尿路感染的诊疗水平,减缓细菌耐药性的发展并保证受者用药安全和有效性,中华医学会器官移植学分会组织肾脏移植专家和感染性疾病专家,结合我国肾脏移植术后尿路感染的临床现状,并参考2022版《中国泌尿外科和男科疾病诊断治疗》和2019版《美国移植学会感染性疾病实践指南中实体器官移植受者的尿路感染》,从肾脏移植术后尿路感染的临床分类和定义、流行病学和病因学、诊断和治疗等方面,制定《中国肾脏移植受者尿路感染临床诊疗指南》。

中段尿培养检出B群链球菌的临床意义

目的 探讨中段尿培养中分离出B群链球菌(GBS)的临床意义和耐药性,旨在为临床尿路感染诊治提供依据。方法 通过实验室信息系统搜索2020年2月—2022年12月南京某医院住院和门诊患者中段尿培养分离出GBS的菌株信息,筛选资料完整者,查阅病例资料、尿常规及药敏试验结果。结果 中段尿培养标本共检出非重复细菌9 081株,其中GBS 425株,占比4.7%,位列第6。剔除资料不完整者,共纳入365例患者进行研究。其中男性169例(46.3%),女性196例(53.7%),平均年龄(55.4±15.2)岁。365例检出GBS的患者来源于17个科室,泌尿外科(237例,64.9%)占比最高。患者基础疾病主要包括高血压病136例,糖尿病95例,泌尿系统结石120例,泌尿系统肿瘤98例;211例患者接受了泌尿系统手术,术前均使用了抗菌药物,205例在术后留置导尿管;9例在妊娠中晚期尿液中检出GBS。GBS菌落计数≤10^(4)CFU/mL占36.4%(133例),10^(4)~10^(5)CFU/mL占38.9%(142例),≥10^(5)CFU/mL占24.7%(90例)。有尿路感染症状的患者占24.9%(91例),无症状性菌尿患者占75.1%(274例)。男性中有尿路感染症状者低于女性(19.5%VS 29.6%,P<0.05)。随着尿培养GBS菌落计数增加,有尿路感染症状的患者比例呈升高趋势(P<0.05)。尿培养送检当日尿常规白细胞、白细胞酯酶、亚硝酸盐阳性比率分别为53.2%、50.1%、3.8%。有症状尿路感染患者中尿潜血、白细胞酯酶、白细胞、尿蛋白的阳性率均高于无症状性菌尿患者(均P<0.05)。未发现GBS对青霉素、氨苄西林、万古霉素、利奈唑胺、替加环素耐药,对左氧氟沙星、莫西沙星耐药率在40%左右,对四环素、克林霉素耐药率>60%。结论 尿液中分离出GBS在非妊娠成人中比较常见,有尿路感染症状者仅占少数。尿培养、尿常规结果应结合患者临床症状、体征综合判断。尿液中GBS对多种抗菌药物敏感,临床应根据药敏结果合理用药。

中国肾脏移植受者尿路感染临床诊疗指南

尿路感染是肾脏移植术后最常见的感染性并发症。为了进一步降低肾脏移植术后受者尿路感染的发生率,提高中国肾脏移植术后受者尿路感染的诊疗水平,减缓细菌耐药性的发展并保证受者用药安全和有效性,中华医学会器官移植学分会组织肾脏移植专家和感染性疾病专家,结合我国肾脏移植术后尿路感染的临床现状,并参考2022版《中国泌尿外科和男科疾病诊断治疗》和2019版《美国移植学会感染性疾病实践指南中实体器官移植受者的尿路感染》,从肾脏移植术后尿路感染的临床分类和定义、流行病学和病因学、诊断和治疗等方面,制定《中国肾脏移植受者尿路感染临床诊疗指南》。

妊娠期无症状菌尿65例临床分析

目的:探讨妊娠期无症状菌尿(ASB)的临床特点。方法:回顾性分析近10年在北京妇产医院建册、产检、分娩的65例妊娠期ASB产妇及同时间内非ASB产妇150例的临床资料,比较两组产妇的一般情况、妊娠期并发症及新生儿结局,分析ASB病原学特点。结果:ASB组初产妇占比61.5%,小于对照组的84%;分娩孕周ASB组(36.5±5.7)周小于对照组的(38.5±2.2)周;ASB组低出生体重儿发生率为10.8%,明显高于对照组的2.0%;ASB组早产、胎儿生长受限、妊娠期高血压疾病的发病率分别为23.1%、26.2%、29.2%,明显高于对照组的6.7%、5.3%、4.7%(P<0.05)。两组孕妇孕晚期或发病时的粒细胞/淋巴细胞数比值(NLR)分别为3.27±1.33、5.14±0.96,均高于孕初期的4.47±1.82、3.84±1.41(P<0.05),但两组间NLR差异无统计学意义。两组产妇年龄、孕次、胎膜早破发生率、新生儿Apgar评分比较差异无统计学意义。病例组致病菌以大肠埃希菌为主,对哌拉西拉舒巴坦、头孢曲松、头孢呋辛、头孢他啶等多种抗生素存在耐药性。结论:妊娠期ASB与不良妊娠结局的发生有关,主要致病菌为以大肠埃希菌为主的革兰阴性杆菌。

Data Analytics on Unpredictable Pregnancy Data Records Using Ensemble Neuro-Fuzzy Techniques

The immune system goes through a profound transformation during pregnancy,and certain unexpected maternal complications have been correlated to this transition.The ability to correctly examine,diagnoses,and predict pregnancy-hastened diseases via the available big data is a delicate problem since the range of information continuously increases and is scalable.Many approaches for disease diagnosis/classification have been established with the use of data mining concepts.However,such methods do not provide an appropriate classification/diagnosis model.Furthermore,single learning approaches are used to create the bulk of these systems.Classification issues may be made more accurate by combining predictions from many different techniques.As a result,we used the Ensembling of Neuro-Fuzzy(E-NF)method to perform a high-level classification of medical diseases.E-NF is a layered computational model with self-learning and self-adaptive capabilities to deal with specific problems,such as the handling of imprecise and ambiguous data that may lead to uncertainty concerns that specifically emerge during the classification stage.Preprocessing data,Training phase,Ensemble phase,and Testing phase make up the complete procedure for the suggested task.Data preprocessing includes feature extraction and dimensionality reduction.Besides such processes,the training phase includes the fuzzification process of medical data.Moreover,training of input data was done using four types of NF techniques:Fuzzy Adaptive Learning Control Network(FALCON),Adaptive Network-based Fuzzy Inference System(ANFIS),Self Constructing Neural Fuzzy Inference Network(SONFIN)and/Evolving Fuzzy Neural Network(EFuNN).Later,in the ensemble phase,all the NF methods’predicted outcomes are integrated,and finally,the test results are evaluated in the testing phase.The outcomes indicate that the method could predict impaired glucose tolerance,preeclampsia,gestational hypertensive abnormalities,bacteriuria,and iron deficiency anaemia better than the others.In addition,the model exposed the capability to be utilized as an autonomous learning strategy,specifically in the early stages of pregnancy,examinations,and clinical guidelines for disease interventions.

不同尿液引流方法的尿液检查分析

目的探讨不同引流方法引起菌尿症的机率。方法通过对留置尿管持续引流、留管后膀胱冲洗及肾盂输尿管支架导管引流三组患者的尿液，在即刻、第２、４、７、１０、１４天后进行细菌培养、药敏和检查分析。结果持续引流组较膀胱冲洗组尿培养出现菌尿的机率稍低，７天菌尿出现率分别为３３．３％和４６．７％，两组比较无显著性差异，但支架管引流组出现菌尿例数明显要少，７天菌尿出现率仅７．１％，与前两组比较有显著性差异，培养出的细菌对大多数抗生素不敏感。结论留置尿管期间膀胱冲洗并不降低菌尿的发生率，细菌通过尿管周围间隙侵入是尿管相关性感染的重要途径，尿液中的细菌对多种抗生素耐药，应引起重视。

UF-100型尿沉渣检测仪测定红细胞影响因素的研究

目的 探讨草酸钙、非晶形盐、细菌、酵母菌在UF 10 0型尿沉渣全自动检测仪分析中对红细胞检测的干扰。方法 采用UF 10 0型尿沉渣全自动检测仪分析法、干化学分析法、镜检法共分析了 2 6 34份住院患者尿液标本 ,并将三者结果进行了比较。结果 单纯或混合性草酸钙、非晶形盐尿液标本 ,UF 10 0检测红细胞结果假阳性率为 95 % ;菌尿UF 10 0检测红细胞结果的假阳性率为 2 8% ;含酵母菌尿液UF 10 0检测红细胞结果假阳性率为 4 0 % ;正常对照组UF 10 0检测红细胞结果假阳性率为 5 %。与对照组相比 ,三者差异均有显著性 (P <0 .0 1)。结论 在UF 10 0型尿沉渣全自动检测仪分析中 ,草酸钙、非晶形盐、菌尿、酵母菌对红细胞检测的结果干扰很大 ,这对尿液检测质量控制具有重要的意义。将这 3种方法联合应用 ,可以提高检测结果的准确度 ,具有较高的临床应用价值。

肾病患者无症状尿路感染的临床研究

目的 探讨常见肾病患者无症状尿路感染、影响因素、菌谱特点及治疗。方法 对 383例肾病患者进行清洁中段尿细菌培养 ,对无症状性菌尿 (ABU)进行菌群鉴定及药物敏感分析 ,并予以抗菌治疗 3d～ 2周。结果 ABU的发生率 10 .71% ,院医感染占 36 .5 9% ;影响因素有肾病类型及是否应用激素和免疫抑制剂等 ,以革兰阴性杆菌为主 (94 .0 0 % ) ,其中以大肠埃希菌为优势菌群 ,其次为产碱菌属、奇异变形菌及产气肠杆菌 ;大肠埃希菌对氨苄西林、庆大霉素及诺氟沙星等耐药率较高 ;ABU治愈率达 95 .83%。结论 ABU在肾病患者中并不少见 ,是肾病复发的重要因素 ,以革兰阴性杆菌为主 ,耐药率高 ,其彻底有效治疗可提高肾病的疗效。

UF-100尿沉渣分析仪及干化学分析在筛检尿路感染中的应用

目的 用中段尿定量细菌培养作为金标准 ,比较UF 1 0 0尿沉渣分析仪 (简称UF 1 0 0 )及干化学分析试验在筛检尿路感染 (UTI)中的可靠性。方法 对 36 9份中段尿标本做细菌培养菌落计数和UF 1 0 0及干化学分析 ,并比较结果。结果 91例培养出细菌 ,占 2 4 .7% ;在UF 1 0 0细菌计量≥ 2 75 0 μl,白细胞≥ 2 0 μl,且干化学分析中白细胞酯酶和亚硝酸盐试验为阳性时 ,待检标本的特异性和阳性预示值最大 ,分别为 99.3%、92 .0 % ;但此时敏感性较低 ,仅为 2 5 .3% ,且假阴性例数较高达 6 8例 ,占 1 8.4 %。结论 UF 1 0 0、干化学分析单独或联合运用均不能准确预见尿培养结果 。

后腹腔镜输尿管切开取石术治疗输尿管上段结石合并感染的临床观察

目的探讨后腹腔镜下上段输尿管切开取石术治疗输尿管上段结石合并感染的安全性和有效性。方法回顾性分析2015年9月至2018年9月解放军联勤保障部队九一〇医院73例输尿管上段结石合并感染病人的临床资料。其中,30例行后腹腔镜输尿管上段切开取石术(腔镜组),26例行经皮肾镜碎石术(肾镜组),17例行输尿管软镜碎石术(软镜组)。术前均按细菌药敏结果抗感染治疗5~11 d。术前出现全身炎症反应(SIRS)的病人术前予行病侧输尿管逆行插管引流或肾造瘘引流等处理,待降钙素原/尿常规白细胞计数恢复正常或接近正常后行手术治疗。记录各组病例手术成功率、术后1个月结石取净率、术后降钙素原(PCT)值、术后抗生素使用天数等。结果腔镜组、肾镜组、软镜组三组一期手术成功率分别为100.00%、92.31%、94.12%,不同组一期手术成功率差异无统计学意义(P>0.05);三组1个月后结石取净率分别100.00%、88.46%、88.24%,不同组1个月后结石取净率差异无统计学意义(P>0.05);三组术后PCT值明显升高分别为6.67%、30.77%、35.29%,不同组术后PCT值明显升高百分比差异有统计学意义(P<0.05);三组术后抗生素使用天数分别为(2.20±0.76)d、(4.42±3.26)d和(4.76±3.61)d,不同组术后抗生素使用天数差异有统计学意义(P<0.05),肾镜组和软镜组术后抗生素使用天数均高于腔镜组(P<0.05)。结论后腹腔镜下输尿管切开取石术安全、有效,创伤小,恢复快,可作为治疗输尿管上段结石合并感染的推荐方案。

菌尿对两种全自动尿沉渣分析仪检测尿红细胞的影响

目的探讨不同菌种、不同浓度细菌对Sysmex UF-1000i和IRISIQ-200全自动尿沉渣分析仪检测尿红细胞的影响,比较两种全自动尿沉渣分析仪检测尿红细胞时的抗细菌干扰能力。方法不同浓度的红细胞尿液加入不同菌种、不同浓度的细菌后分别用Sysmex UF-1000i和IRISIQ-200进行检测,比较加入细菌前后检测结果的差异。结果铜绿假单胞菌、金黄色葡萄球菌和大肠埃希菌对Sysmex UF-1000i和IRISIQ-200检测尿中红细胞没有显著影响,白色念珠菌和热带念珠菌可干扰Sysmex UF-1000i和IRISIQ-200对尿中红细胞的检测,但两种仪器受干扰程度有差异。结论 Sysmex UF-1000i和IRISIQ-200对尿红细胞检测在一定程度上可受到真菌的影响,结果报告应结合干化学检测和手工显微镜检查。