Do clinical microbiology laboratories report complete bacteriology in urine from patients with long-term urinary catheters?
Do clinical microbiology laboratories report complete bacteriology in urine from patients with long-term urinary catheters?
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临床微生物学实验室是否报告长期导尿管患者尿液中完整的细菌学结果？
DOI：
10.1128/jcm.24.3.400-404.1986
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发表时间：
1986
影响因子：
9.4
通讯作者：
Tenney,JH
中科院分区：
文献类型：
--
作者：
Damron,DJ;Warren,JW;Chippendale,GR;Tenney,JH
与长期导尿管（留置时间超过或等于 30 天）相关的菌尿似乎是美国医疗机构中最常见的医院感染。这种菌尿是多种微生物和动态的，并伴有发烧、导管阻塞、菌血症和死亡。我们将我们的研究实验室关于长期留置导尿疗养院患者尿液中细菌的报告与两个商业实验室的报告进行了比较。商业实验室分离出的细菌种类显着减少，浓度为 10(5) CFU/ml 尿液样本。研究和商业实验室以相当的频率分离出被公认为非导尿患者尿路感染原因的微生物（大肠杆菌、奇异变形杆菌、肺炎克雷伯菌）。然而，其他微生物，包括不常见的尿路病原体，如斯氏普罗维登斯菌和摩根氏菌，它们实际上是这些长期导尿患者中最常见的菌尿菌种，但商业实验室分离的频率明显较低。造成差异的原因尚不清楚，但可能涉及使用不同的技术。更完整的报告可能有助于更好地了解长期导管的多种微生物菌尿及其相关并发症。反过来，这可能会改善疗养院的患者护理和感染控制。
Bacteriuria associated with long-term urinary catheters (those in place for greater than or equal to 30 days) appears to be the most common nosocomial infection in U.S. medical care facilities. This bacteriuria is polymicrobial and dynamic and accompanied by fevers, catheter obstructions, bacteremias, and deaths. We compared the reporting by our research laboratory of bacteria present in urine from long-term-catheterized nursing home patients with that by two commercial laboratories. The commercial laboratories isolated significantly fewer bacterial species at 10(5) CFU/ml of urine specimen. Organisms well recognized as causes of urinary tract infections in noncatheterized patients (Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae) were isolated in comparable frequencies by both the research and commercial laboratories. However, other organisms, including uncommon uropathogens like Providencia stuartii and Morganella morganii, which were actually among the most frequent bacteriuric species in these long-term-catheterized patients, were isolated significantly less frequently by the commercial laboratories. Reasons for the discrepancies are unclear but may involve use of different techniques. More complete reporting may lead to better understanding of the polymicrobial bacteriuria of long-term catheters and its associated complications. This, in turn, may result in improved patient care and infection control in nursing homes.