摘要
目的探讨感染性结石患者中段尿细菌培养病原菌类型与结石成分的关系。方法回顾性分析2016年1月至2020年12月清华大学附属北京清华长庚医院收治的989例感染性结石患者的临床资料。男545例(55.1%),女444例(44.9%),男女比例6∶5。年龄(48±14)(1~88)岁。体重指数(24.8±4.3)kg/m2。合并糖尿病109例,高血压病235例。结石位于左侧396例,右侧333例,双侧260例。单发结石264例,多发结石334例,鹿角形结石391例。结石最大径(33.4±26.5)mm。收集清洁中段尿行细菌培养。所有患者均行经皮肾镜取石术收集结石标本行结石成分分析。记录尿细菌培养和结石成分分析结果,比较产脲酶菌株和非产脲酶菌株间结石成分的差异。结果本研究989例中,纯感染性结石259例(26.2%),混合感染性结石131例(13.2%),含感染性结石成分标本599例(60.6%)。纯感染性结石中,纯六水磷酸铵镁结石56例(5.7%),纯碳酸磷灰石35例(3.5%),同时有六水磷酸铵镁和碳酸磷灰石成分168例(17.0%)。989例中尿细菌培养阳性627例(63.4%),其中检出率前三位的产脲酶菌分别为解脲脲原体(94例,31.1%)、奇异变形杆菌(58例,19.2%)和葡萄球菌属(36例,11.9%),奇异变形杆菌常见于纯感染性结石(44例,75.9%),而解脲脲原体和葡萄球菌属常见于含感染性结石成分标本(68例,72.4%;27例,75.0%)。检出率前三位的非产脲酶菌分别为大肠埃希菌(175例,53.9%)、肠球菌属(76例,23.4%)和链球菌属(35例,10.8%),大肠埃希菌常见于含感染性结石成分标本(78例,44.5%)和纯感染性结石(61例,34.9%),肠球菌属和链球菌属常见于含感染性结石成分标本(42例,55.3%;26例,74.3%)。259例纯感染性结石中检出率前三位的病原菌为大肠埃希菌61例(23.6%)、奇异变形杆菌44例(17.0%)和肠球菌属20例(7.7%);131例混合感染性结石中检出率前三位的病原菌为大肠埃希菌36例(27.5%)、肠球菌属14例(10.7%)和解脲脲原体10例(7.6%);599�
Objective To study the relationship of pathogenic bacteria in midstream urine culture and stone composition of patients characteristics with infection stones.Methods Between January 2016 and December 2020,989 patients with infectious stones who attended Tsinghua Chang Gung Hospital,affiliated with Tsinghua University,for surgical treatment were enrolled in the study.There were 545 male and 444 female patients,with the mean age(48±14)years.The left and right side stones were 396 and 333,respectively.There were 260 bilateral stones,264 single stones,334 multiple stones,and 391 deer-stalker-shaped stones.The maximum diameter of stones was(33.4±26.5)mm,combined with diabetes in 109 cases and hypertension in 235 cases.Clean middle-urine was collected for bacterial culture,and intraoperative stone specimens were collected by percutaneous nephrolithotomy(PCNL).Personal characteristics of the patient such as gender,age,body mass index,clinical information such as stone size,location,comorbidities,results of urine culture and stone composition were recorded.The differences of infectious stone composition was analyzed between urease-producing,non-urease-producing bacteria.Results Among the 989 patients with infectious stones,259 were pure infectious stones,131 were mixed infectious stones,and 599 were combined with infectious stone components.Urine cultures were positive in 627(63.4%)patients with infectious stones.The predominant urease-producing bacteria included Ureaplasma urealyticum(94 case),Proteus mirabilis(58 case),and Staphylococcus spp.(36 case).Pure infectious stones were common in Proteus mirabilis,while combined with infectious stone components were common in Ureaplasma urealyticum and Staphylococcus spp.The predominant non-urease-producing bacteria included Escherichia coli(175 case),Enterococcus spp.(76 case)and Streptococcus spp.(35 case).Escherichia coli commonly contained in infectious stone components and pure infectious stones,whereas Enterococcus spp.and Streptococcus spp.commonly contained in infect
作者
丁西杰
胡卫国
李健
李建兴
陈国俊
靳松
丁天福
白文洁
王碧霄
蒋红梅
Ding Xijie;Hu Weiguo;Li Jian;Li Jianxing;Chen Guojun;Jin Song;Ding Tianfu;Bai Wenjie;Wang Bixiao;Jiang Hongmei(Department of Urology,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China;Department of Urology,Qinghai University Affiliated Hospital,Xining 810000,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2022年第10期734-738,共5页
Chinese Journal of Urology
关键词
感染性结石
大肠埃希菌
解脲脲原体
结石成分分析
Infection stones
Escherichia coli
Ureaplasma urealyticum
Stone composition analysis
