尿路感染発症における尿流停滞の意義

Abstract

尿路感染発症の因子としての尿流停滞の意義について, 基礎的および臨床的に検討した.1)無処置および糖尿病マウスの上行性腎盂腎炎モデルにおいて, 膀胱内菌液接種後外尿道口クランプ時間が長くなるほどそのID50値は低下し, 膀胱内尿停滞による易感染化が示された.2)前立腺術後6ヵ月以内におこったUTIについて, 残尿あり, 残尿なしの2群に分け, その起炎菌種の内訳, 膿尿, 細菌尿の程度を検討したところ, 前者で複数菌感染がやや多かったが, その他の項目で差はなかった.3)上記2群にセフェム系抗菌薬を投与しその薬効を比べたところ, 両群に差はなかった.以上の結果から, 尿流停滞は易感染因子と考えられたが, 治療上は残尿という因子に限っていえば難治因子とはなっていないことが明らかとなった

A basic and clinical study was made on the significance of stagnancy of urinary flow as a factor causing urinary tract infections. A bacterial solution was inoculated into the bladder of untreated and diabetic mice with model ascending pyelonephritis. The longer the external urethral opening was clamped, the lower became the value of ID50, thus showing infection easily caused by urinary stagnancy in the bladder. Patients who had UTI within 6 months after prostatic operation were divided into two groups, one with residual urine and the other without residual urine. Then, the type of the causative organism, and the severity of pyuria and bacteriuria were determined. In the former, there were slightly more patients with infection caused by plural bacteria. However, no other differences were observed. The administration of cephem antibiotics revealed no differences in effectiveness between the two groups. In conclusion, stagnancy of urinary flow has been considered a factor easily causing infection. However, so far as residual urine is concerned, it is not an intractable factor in treatment.