Chronic Urinary Infection in Overactive Bladder Syndrome: A Prospective, Blinded Case Control Study.
Chronic Urinary Infection in Overactive Bladder Syndrome: A Prospective, Blinded Case Control Study.
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DOI：
10.3389/fcimb.2021.752275
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发表时间：
2021
影响因子：
5.7
通讯作者：
Conlan RS
中科院分区：
文献类型：
--
作者：
Khan Z;Healey GD;Paravati R;Berry N;Rees E;Margarit L;Gonzalez D;Emery S;Conlan RS
旨在调查患有膀胱过度活动症 (OAB) 症状且通过常规清洁捕获中流尿培养未发现临床感染证据的女性是否具有亚临床感染的替代指标。该研究是一项前瞻性、盲法病例对照研究，招募了 147 名参与者，其中包括 73 名 OAB 患者和 74 名对照者。 OAB 组由至少 18 岁且出现 OAB 症状超过 3 个月的女性患者组成。通过显微镜检查干净捕获的中流尿样是否有脓尿；进行常规和强化微生物培养，并通过 ELISA 检查 10 种不同细胞因子、趋化因子和前列腺素的存在。两组参与者的平均年龄和体重指数相似。 OAB 组和对照组之间患有脓尿的女性人数没有显着差异 (p = 0.651)。 OAB 组中 3 名 (4%) 女性的常规实验室培养结果呈阳性，而 17 名 (23.2%) OAB 患者中的增强培养分离出细菌。在对照组中，使用常规实验室培养未观察到阳性培养物，而增强培养在 8 名患者（10.8%）中分离出细菌。 OAB组和对照组之间PGE2、PGF2α、MCP-1、sCD40L、MIP-1β、IL12p70/p40、IL12/IL-23p40、IL-5、EGF和GRO-α的浓度没有观察到显着差异。有 OAB 症状的患者在尿液强化培养中发现明显的细菌生长，而通过常规培养通常无法检测到，提示存在亚临床感染。因此，应常规使用强化培养技术来有效诊断和治疗 OAB。
To investigate whether women with overactive bladder (OAB) symptoms and no evidence of clinical infection by conventional clean-catch midstream urine cultures have alternative indicators of sub-clinical infection. The study was a prospective, blinded case-control study with 147 participants recruited, including 73 OAB patients and 74 controls. The OAB group comprised female patients of at least 18 years of age who presented with OAB symptoms for more than 3 months. Clean-catch midstream urine samples were examined for pyuria by microscopy; subjected to routine and enhanced microbiological cultures and examined for the presence of 10 different cytokines, chemokines, and prostaglandins by ELISA. The mean age and BMI of participants in both groups were similar. No significant difference in the number of women with pyuria was observed between OAB and control groups (p = 0.651). Routine laboratory cultures were positive in three (4%) of women in the OAB group, whereas the enhanced cultures isolated bacteria in 17 (23.2%) of the OAB patients. In the control group, no positive cultures were observed using routine laboratory cultures, whereas enhanced culture isolated bacteria in 8 (10.8%) patients. No significant differences were observed in the concentrations of PGE2, PGF2α, MCP-1, sCD40L, MIP-1β, IL12p70/p40, IL12/IL-23p40, IL-5, EGF and GRO-α between the OAB and control groups. Patients with OAB symptoms have significant bacterial growth on enhanced culture of the urine, which is often not detectable through routine culture, suggesting a subclinical infection. Enhanced culture techniques should therefore be used routinely for the effective diagnosis and management of OAB.