Prevalence and Antimicrobial Susceptibility Pattern of Asymptomatic Urinary Tract Infections of Bacterial and Parasitic Origins among University Students in Redemption Camp, Ogun State, Nigeria

Asymptomatic urinary tract infections (UTIs) of bacterial and parasitic origins occur in both males and females where bacteria and/or parasites are present in the urine, with the absence of clinical signs or symptoms in the host. Using microbiological methods, mid-stream urine collected from sixty (60) Redeemer’s University students comprising apparently healthy 30 male and 30 female undergraduate students were examined. The samples were cultured on CLED and MacConkey agar. Bacteriuria was observed in 15 (25%) of the samples while there was no significant growth in 34 (56.7%), and no growth in 11 (18.3%). Prevalence of significant bacteriuria was higher in females 11 (73.3%) than males 4 (26.7%). The bacteria isolated were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Streptococcus spp, and Klebsiella spp. The isolates were resistant to amoxycillin, augumentin and cotrimoxazole but most were highly susceptible to ofloxacin. Schistosoma haematobium and Trichomonas vaginalis were the two asymptomatic UTI-causing parasites isolated from the samples used in this study. Out of the 30 males examined using the microscopy method, 1 (1.67%) had T. vaginalis while the females had higher prevalence of 2 (3.33%) out of 30 females examined. Out of the overall participants examined for S. haematobium eggs, 15 (25%) had Schistosomiasis in which the males had higher prevalence of 10 (33.33%) while the females had 5 (16.67%). These results are lower than those observed in similar rural communities in Nigeria possibly due to effective health education, availability of potable water, higher-than average income and hygienic practices on Redemption Camp, Ogun State, Nigeria.

Prevalence and Antibiotic Resistance of Urinary Tract Pathogens, with Molecular Identification of Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp., Using Multiplex Real-Time PCR

Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resistance necessitates updating diagnostic techniques to ensure higher sensitivity and specificity, especially with advancements in science and medicine. This study aimed to evaluate the prevalence of UTIs and antibiotic resistance profiles through urine culture, as well as to identify Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp. in urine samples using a molecular approach with multiplex real-time PCR. From May 3 to July 25, 2023, at the Pietro Annigoni Biomolecular Research Center (CERBA) and Saint Camille Hospital of Ouagadougou (HOSCO), 209 urine samples collected from patients with suspected UTIs were analyzed using both urine culture and multiplex real-time PCR. Among the 209 patients, 52.15% were male and 47.85% female, with an average age of 46.87 ± 21.33 years. Urine cultures revealed an overall UTI prevalence of 23.44%, with a prevalence of 8.13% in men versus 15.31% in women (P = 0.023). The bacterial prevalence rates were as follows: Escherichia coli (12.92%), Klebsiella spp. (7.18%), Enterobacter cloacae (1.44%), Staphylococcus aureus (0.96%), and other bacteria. Klebsiella spp. demonstrated 100% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, while Escherichia coli showed 96.2% and 65.4% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, respectively. PCR analysis of the target bacteria revealed mono-infection prevalence rates of Klebsiella pneumoniae (10.39%), Klebsiella oxytoca (7.79%), and Acinetobacter spp. (7.79%), along with a co-infection prevalence rate of Klebsiella pneumoniae/Acinetobacter spp. (1.30%). This study demonstrated that PCR, with its high sensitivity and specificity, could effectively distinguish Klebsiella pneumoniae from Klebsiella oxytoca and detect Acinetobacter spp. in less than 24 hours—something urine culture alone could not achieve. The relative ease of automating urine PCR testing, combined with its diagnostic accuracy and rapid turnaround time, makes it a valuable addition to modern medical practice for the laboratory diagnosis of UTIs.

Clinical Investigation on the Correlation between Lower Urinary Tract Infection and Cystitis Glandularis

Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.

Contribution of the Urine Dipstick to Urinary Tract Infection Diagnosis among Children in Two Hospitals in Cotonou-Benin

Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood pressure and renal failure. The purpose of this study was to determine the contribution of a urine dipstick (UD) to the diagnosis of urinary infections among children at the CNHU-HKM and the Lagoon Mother and Child University Teaching Hospital (CHU-MEL) of Cotonou. Patients and Methods: This study is a cohort, descriptive and analytical study focused on children with suspected urinary infections in the pediatric units of the CNHU-HKM and CHU-MEL of Cotonou from March 25 to August 25, 2015. Results: Two hundred and four children out of a total of 5125 admitted children (4%) presented with at least one clinical sign of a urinary tract infection. Children under 36 months of age were predominant (41%). The main clinical signs of urinary infections were fever (60.8%) and urinary disorders (38.2%). The urinary dipstick test was positive in 145 children (71.2%). A urinary tract infection was confirmed by urine culture in 38 children (18.6%). In cases with leucocyturia- and nitrituria-positive urine dipstick tests, the sensitivity was estimated to be 13.2%, and the specificity was 95.2%, with a negative predictive value (NPV) of 82.8%. Only when the leucocyturia test was positive, the sensitivity was 76.3%, and the specificity was 31.9%. When the leucocyturia test was negative, the specificity was estimated to be 94%, and the sensitivity was 83% in the nitrituria-positive cases and 15.8% in the nitrituria-negative cases. The main isolated pathogens were Escherichia coli (n = 21) and Klebsiella pneumoniae (n = 14). Conclusion: In our environment, a negative leucocyturia test may help exclude urinary tract infections in most cases.

尿液白细胞检验联合细菌定量计数与尿液(细菌+真菌)培养的比较分析

目的 比较尿液白细胞检验联合细菌定量计数与尿液(细菌+真菌)培养的结果。方法 选取在2022年1月至2022年12月来本院就诊且行尿常规检验及尿液(细菌+真菌)培养的1247例患者,分析朗迈全自动尿液分析仪进行尿常规检测及尿液(细菌+真菌)培养检测结果。结果 朗迈全自动尿液分析仪检测的尿白细胞酯酶定性和尿沉渣白细胞计数与尿液(细菌+真菌)培养结果进行比较,差异具有统计学意义(P <0.01)。尿沉渣细菌定量计数与尿液(细菌+真菌)培养结果进行比较,差异具有统计学意义(P <0.01)。结论 朗迈全自动尿液分析仪对尿路感染的诊断具有一定的临床价值,但尿液(细菌+真菌)培养依然是临床诊断尿路感染的金标准,在进行尿常规检验的同时进行尿(细菌+真菌)培养,以免出现误差。

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》。

细菌定量计数联合尿沉渣白细胞检验在尿路感染诊断中的应用价值分析

目的观察分析细菌定量计数联合尿沉渣白细胞检验在尿路感染诊断中的应用价值。方法200例疑似尿路感染患者,均接受细菌定量计数、尿沉渣白细胞检验及尿细菌培养。分析尿细菌培养结果,以尿细菌培养为金标准,比较细菌定量计数、尿沉渣白细胞单一检验及联合检验的诊断效能。结果200例疑似尿路感染患者经尿细菌培养诊断,阳性标本为104例,阳性率为52.00%。以尿细菌培养为金标准,联合检验对尿路感染的诊断敏感性、特异性、阳性预测值及阴性预测值分别为98.08%、96.88%、97.14%、97.89%,细菌定量计数检验对尿路感染的诊断敏感性、特异性、阳性预测值及阴性预测值分别为80.77%、69.79%、74.34%、77.01%,尿沉渣白细胞检验对尿路感染的诊断敏感性、特异性、阳性预测值及阴性预测值分别为91.35%、92.71%、93.14%、90.82%,联合检验对尿路感染的诊断敏感性、特异性、阳性预测值及阴性预测值均高于细菌定量计数检验,敏感性、阴性预测值高于尿沉渣白细胞检验(P<0.05)。结论在尿路感染诊断中,应用细菌定量计数联合尿沉渣白细胞检验的结果与尿细菌培养更相近,具有较高的诊断价值。

泌尿系感染患者中段尿培养病原菌种类分布及耐药性

目的 分析泌尿系感染(UTI)患者中段尿培养病原菌种类分布及耐药性。方法 选择2022年10月—2023年2月郯城县第一人民医院收治的150例UTI患者作为研究对象,采集所有受检者的中段尿液样本,进行病原菌培养及耐药试验,并对UTI患者的科室分布、病原菌培养及耐药试验结果进行分析。结果 150例UTI患者中,58例(占38.67%)来自泌尿外科,34例(22.67%)来自肾内科,21例(14.00%)来自重症监护病房(ICU)。在150例UTI患者提供的中段尿液样本中共分离出病原菌163株,其中革兰阴性(G^(-))杆菌108株(占66.26%),革兰阳性(G^(+))菌42株(占25.77%),真菌13株(占7.98%)。G^(-)菌以大肠埃希菌(占63.89%)和肺炎克雷伯菌(占17.59%)为主,G^(+)菌以粪肠球菌(占47.42%)和屎肠球菌(占19.05%)为主。大肠埃希菌对氨苄西林、诺氟沙星、复方新诺明的耐药率均较高,分别为95.65%、86.96%、52.17%;肺炎克雷伯菌对氨苄西林、诺氟沙星的耐药率较高,分别为100.00%、68.42%;粪肠球菌对红霉素、呋喃妥因、万古霉素的耐药率较高,分别为52.38%、90.48%、57.14%;屎肠球菌对氨苄西林、环丙沙星、左氧氟沙星、红霉素、青霉素、万古霉素菌均存在极高的耐药性,达到100.00%。结论 UTI的主要病原菌为G^(-)菌,其中以大肠埃希菌和肺炎克雷伯菌最常见,不同病原菌的耐药性不同,在治疗过程中建议结合病原菌耐药性试验结果选择抗菌药物,以提升治疗效果。

尿八联检验联合定量尿培养在尿路感染中的诊断效能

目的探究尿路感染使用尿八联检验联合定量尿培养的诊断效能。方法回顾性分析2021年1月—2022年12月昆山市康复医院就诊收治的120例尿路感染、肾盂肾炎、间质性膀胱炎患者的资料,其中尿路感染患者109例,肾盂肾炎患者5例,间质性膀胱炎患者6例。收集患者尿八联检验、定量尿培养检查结果,对比不同检查方式的受试者工作特征曲线(Receiver Operating Characteristic Curve,ROC)下面积,分析尿八联单独检验与联合定量尿培养检查的诊断效能。结果经尿八联单独检查确诊93例,经尿八联检验联合定量尿培养检查确诊108例,尿八联检验的准确率低于尿八联检验联合定量尿培养,差异有统计学意义(P<0.05)。尿八联检验的ROC下面积(Area Under Curve,AUC)为0.699(95%CI=0.609~0.780)、灵敏度为85.32%、特异性为54.55%、Youden指数为0.399,尿八联检验联合定量尿培养AUC为0.950(95%CI=0.894~0.981)、灵敏度为99.08%、特异性为90.91%、Youden指数为0.900,两组对比,差异有统计学意义(Z=3.220,P<0.05)。结论对于尿路感染的诊断,尿八联检验联合定量尿培养具有较高的诊断效能,相较于尿八联单独检验,其在灵敏度、特异性和准确率方面均表现得更为优越。

尿路感染诊断中尿沉渣细菌定量分析与细菌培养的对比及效能评价

目的 探讨尿路感染诊断中运用尿沉渣细菌定量分析与细菌培养的效果差异。方法 非随机选取2019年2月—2023年8月南京鼓楼医院集团仪征医院收治的200例疑似尿路感染的患者为研究对象,全部接受尿沉渣细菌定量分析,并以细菌培养作为金标准,对尿沉渣细菌定量分析的诊断价值进行观察,通过kappa值进行一致性分析。结果 细菌培养结果显示阳性157例、阴性43例,尿沉渣细菌定量分析提示阳性155例、阴性45例。尿沉渣细菌定量分析的阳性检出率与细菌培养相比,差异无统计学意义(P>0.05)。尿沉渣细菌定量分析的灵敏度为98.73%(155/157)、特异度为100.00%(43/43)、准确度为98.50%(197/200)、阳性预测值为100.00%(155/155)、阴性预测值为95.56%(43/45),与细菌培养结果一致性较好(Kappa=0.97)。尿沉渣细菌定量分析对大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、变形菌、鲍氏不动杆菌、链球菌、真菌诊断符合率均超过95.00%。结论 尿沉渣细菌定量分析与细菌培养在临床尿路感染的诊断中具有较高的一致性,具有较高诊断效能。

尿沉渣革兰染色镜检在尿路感染诊断中的价值

目的:研究尿沉渣革兰染色镜检对尿路感染的诊断价值。方法:分析2021年8月-2021年12月632例送检清洁中段尿培养的门诊及住院患者结果,以临床诊断作为金标准,分析尿沉渣革兰染色镜检对尿路感染的诊断性能。结果:632例患者标本中尿培养阳性218例(34.5%),尿路感染最常见的病原菌为大肠埃希菌,其次为肠球菌属和葡萄球菌属。白细胞、菌量、尿培养的诊断比值比均大于1,白细胞的诊断比值比最高,菌量和尿培养的诊断比值比近似。以白细胞少量为诊断尿路感染的阈值,灵敏度和特异度均较高(分别为88%,79%),约登指数最大(0.67),诊断比值比最高(29.20)。尿沉渣革兰染色镜检观察到的病原菌形态学特征与培养结果一致。结论:尿沉渣革兰染色镜检作为一种快速筛查实验,在尿路感染诊断中具有较高临床价值。

尿干化学法联合尿沉渣法在尿路感染患者诊断中的应用价值研究

目的:探究尿干化学法联合尿沉渣法在尿路感染患者诊断中的应用效果。方法:选取2022年5月—2023年10月延安市延川县人民医院收治的疑似尿路感染患者54例作为观察组,同期健康体检者54例作为对照组,均进行尿干化学法、尿沉渣法检测及中段尿体外细菌培养,以尿液细菌培养结果为“金标准”,分析两组患者尿常规指标水平,以及尿干化学法、尿沉渣法与尿干化学法联合尿沉渣法检查的阳性及阴性检出情况、诊断效能。结果:观察组WBC、BACT高于对照组,差异有统计学意义(P<0.001);细菌培养结果显示,54例疑似尿路感染患者中阳性40例,阴性14例;尿干化学法联合尿沉渣法检查的灵敏度、准确度高于尿干化学法、尿沉渣法,差异有统计学意义(P<0.05);尿干化学法、尿沉渣法与尿干化学法联合尿沉渣法检查特异度比较,差异无统计学意义(P>0.05)。结论:尿干化学法联合尿沉渣法在尿路感染患者诊断中的应用价值较高,联合检查诊断效能良好,值得临床借鉴。

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.

Etiology and resistance of asymptomatic bacteriuria isolates among school going children in Sanadaj-Iran

Objective:The objective of this study was to determine the etiology and antimicrobial susceptibility patterns of asymptomatic bacteriuria pathogens isolated among school going children in Sanandaj,Iran.Methods:A total of 1 457 urine samples of 5 to 10 years children from forty different schools of Sanandaj city were screened to see asymptomatic bacteriuria during November 2007 to June 2008.Results:Bacterial colony count of over (105) colony forming units CFU/ mL were found in 28(1.90%) of total cases,with 767(52.64%) girls and 690(47.35%) boys.The highest class-specific prevalence was found in the fourth standard(2.8%) and the lowest in the first standard(1.0%).The dominant bacterial isolates were E.coli 20(74.1%),followed by Klebsiella pneumoniae 04(14.8%) and Staphylococcus aureus 04(14.8%).Cefotaxime,Cefixime,Kanamycin, Co-trimoxazole,nalidicxic acid,nitrofurantoin and Amoxicillin,resistance rates were above 90.0%. Ceftriaxone expressed the highest susceptibility among E.coli isolates.Surprisingly,S.aureus showed 100. 0%resistance to oxacillin.Conclusion:In the present study in which Escherichia coli is the most frequently incriminated as the causative agents.The results show a very serious antibiotic resistance of E.coli isolated. Surveillance and monitoring studies will be essential in preventing of renal scarring or other abnormalities.

尿路感染患者常见病原菌分布及耐药性分析

目的分析徐州医科大学附属医院尿路感染患者尿液标本的病原菌分布及大肠埃希菌对常用抗菌药物的耐药情况,为合理选用抗菌药物提供指导依据。方法收集2021年8月—2022年7月徐州医科大学附属医院送检的3882份自行收集或无菌导出的尿液标本,并进行中段尿培养,分析尿培养阳性标本病原菌分布结果、大肠埃希菌检出科室分布情况及其抗菌药物敏感性。结果3882份送检尿培养标本中尿培养阳性标本共881份(22.69%),其中由单一菌株引起的有846份,由2种混合菌株引起的有35份;共分离出916株病原菌,其中检出512株革兰阴性菌(55.90%),以大肠埃希菌(306株,33.41%)和肺炎克雷伯菌(75株,8.19%)为主;检出革兰阳性菌188株(20.52%),以屎肠球菌(80株,8.73%)和粪肠球菌(27株,2.95%)为主;检出216株真菌(23.58%),以白假丝酵母菌(77株,8.41%)和热带假丝酵母菌(58株,6.33%)为主。尿路致病性大肠埃希菌(UPEC)分离株中8.50%(26/306)分离自门诊患者,91.50%(280/306)分离自住院患者,其中泌尿外科、肾脏内科、风湿免疫科、神经内科和重症监护室(ICU)的检出率依次为32.68%、20.92%、8.50%、6.86%、6.21%。UPEC对替卡西林(88.24%)、头孢呋辛(61.49%)、头孢呋辛酯(62.94%)、左氧氟沙星(72.46%)和复方新诺明(58.03%)的耐药性较高,耐药率均高于50%;对其他抗菌药物较为敏感。结论该院尿路感染标本中病原菌构成复杂、种类多样,其中革兰阴性菌是尿路感染的主要致病菌,以大肠埃希菌占比最多,部分病原菌呈现高水平耐药。患者应积极配合医生开展病原菌鉴定及药物敏感试验,以便合理选用抗菌药物,避免多重耐药菌和新型耐药菌的出现。

尿培养在尿路感染临床诊断中的应用

目的 分析尿培养在尿路感染临床诊断中的应用价值。方法 选取2021年1月—2023年1月盐城市第一人民医院收治的疑似尿路感染患者100例,采集患者尿液标本对其进行尿培养,分析对尿路感染的诊断价值以及对病原菌检出情况。结果 100例疑似为尿路感染患者经临床综合诊断为尿路感染82例(82.00%),尿培养诊断尿路感染80例(80.00%),尿培养诊断尿路感染的灵敏度、特异度、准确度、阳性与阴性预测值分别为95.12%、88.89%、94.00%、97.50%、80.00%。尿培养对上尿路、下尿路感染的检出率分别为100.00%、91.30%,与临床综合诊断结果符合率为95.12%。尿培养与临床综合诊断对尿路感染诊断的Kappa值为0.805,一致性高。结论 尿培养诊断尿路感染的临床价值高,一致性高,值得临床应用。

泌尿外科肾结石合并尿路感染患者病原菌分布和耐药性分析

目的:分析泌尿外科肾结石合并尿路感染患者病原菌分布和耐药性。方法:选取2019年11月至2020年11月该院收治的220例肾结石合并尿路感染患者进行前瞻性研究,并对收集的尿液标本进行病原学培养及药敏试验,观察肾结石合并尿路感染患者病原菌分布情况,分析主要革兰阴性菌、革兰阳性菌对抗菌药物的耐药性。结果:220例肾结石合并尿路感染患者共分离出220株病原菌,其中革兰阴性菌占63.64%(140/220)、革兰阳性菌占22.73%(50/220)、真菌占13.64%(30/220);其中革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主,革兰阳性菌以肠球菌属、凝固酶阴性葡萄球菌为主,真菌以白色假丝酵母菌、热带假丝酵母菌为主;大肠埃希菌对氨苄西林的耐药率最高(89.09%),其次是甲氧苄啶(82.73%),肺炎克雷伯菌对甲氧苄啶、头孢唑林的耐药率最高,均为80.00%,二者对于亚胺培南耐药率较低,均为0;肠球菌属对红霉素的耐药率最高为96.00%,其次为克林霉素(92.00%),凝固酶阴性葡萄球菌对红霉素的耐药率最高为60.00%,其次为青霉素(53.33%),二者对万古霉素的耐药率较低,均为0。结论:泌尿外科肾结石合并尿路感染患者的主要病原菌为革兰阴性菌,且对临床常用抗菌药物具有较高耐药性。

益生菌对儿童导尿管相关尿路感染的预防作用探究

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。