寡源菌属在尿液中的分离与意义

Isolation and significance of Oligella in urine

摘要:

目的 探讨寡源菌属在尿标本中的分离与意义,提高临床对该菌的认识及诊疗水平。方法 回顾性分析某院3例尿培养检出寡源菌的病例资料,并检索数据库相关文献进行复习。结果 该院3例病例中1例患者为无症状菌尿,未使用抗菌药物治疗,进行保肾、控制血糖等支持治疗后好转;2例临床诊断为感染,分别给予磷霉素、莫西沙星治疗后好转。该院3例病例结合文献报道的85例病例复习显示,59例患者为无症状菌尿,27例患者为尿路感染,2例患者有尿失禁症状(不除外尿路感染引起)。尿道寡源菌对除氟喹诺酮类外的多数抗菌药物敏感,但解脲寡源菌表现为体外药敏不确定。结论 寡源菌在泌尿系统中以定植为主,也可以引起尿路感染,该菌在少数尿失禁患者中也可分离到,与尿失禁的关系需进一步研究;该菌种间抗菌药物敏感性存在差异,临床应正确认识该菌在尿标本中检出的意义,合理使用抗菌药物。

Abstract:

Objective To explore the isolation and significance of Oligella in urine specimens, improve clinical awareness, and enhance the level of clinical diagnosis and treatment of the bacterium. Methods Clinical data of 3 patients from whom Oligella was detected in urine cultures in a hospital were retrospectively analyzed, and relevant literatures were retrieved from databases for review. Results Among these 3 cases in this hospital, one patient had asymptomatic bacteriuria and did not receive antimicrobial treatment, after receiving supportive treatments such as kidney protection and blood sugar control, the condition improved. Two cases were clinically diagnosed as infection and improved after treatment with phosphomycin and moxifloxacin, respectively. Three cases in this study and 85 cases in the literature review showed that 59 cases had asymptomatic bacteriuria, 27 cases had urinary tract infections, and 2 cases had symptoms of urinary incontinence (urinary tract infection was possible). Oligella urethralis was susceptible to most antimicrobial agents except fluoroquinolones. However, Oligella ureolytica exhibited uncertain antimicrobial susceptibility. Conclusion Oligella mainly exists in a colonized state in the urinary system and can also cause urinary tract infections, it can also be isolated from a small number of urinary incontinence patients, and its relationship with urinary incontinence needs further research. There are differences in antimicrobial susceptibility among different species of Oligella, clinical practice should correctly understand the significance of detecting this bacteria from urine specimens and use antimicrobial agents rationally.