外傷性脊髄損傷患者の泌尿器科学的研究 第4報: 尿路感染症について

Abstract

On urinary tract infections in patients with traumat i c spinal cord injuries, bacteriological examinations of the urinary bacteria and sensitivity tests of isolated bacteria against Penicillin, Streptomycin, Chloramphenicol, Tetracycline, Erythromycin and Sulfa-isoxazol were performed during Angust 1961. Observations were made on yearly change of sensitivity of urinary bacteria against chemotherapeutic drugs during the period between 1957 and 1961. The results of studies are summerized as follows. 1) Among 51 cases of spinal cord injury, only 3 cases showed no bacterial growth for urinary cultures. The isolated urinary bacteria from 48 patients, totalling 58 strains, cornprized 5.2 % of cocci and 93.1 % of bacilli including about 60 % of E. coli group, 12.1 % pseudomonasa nd 10.3% proteus group. 2) Although E. coli group of b acilli was most frequently recognized as urinary bacilli during the observation period, an increased frequency of pseudomonas and proteus groups and a decreased frequency of Gram-negative cocci were encountered after 1960. 3) The results of sensitivity tests against the above mentioned 6 anti biotics indicated that Streptomycin was the most sensitive drug. All of isolated proteus were sensitive to Streptomycin, while slight sensitivity was demonstrated in below 50 % of E. coli group and below 43 % of pseudomonas. 4) On yearl y change of sensitivity against each antibiotics. All of the drugs tested showed resistance at below 50 % levels with some yearly fructuation, and almost all cases revealed multi-resistance which rapidly increased after 1959. 5) Alternatitve change of infected bacteria was reco gnized regardless treatment, and a tendency of increase in resistence against antibiotics was demonstrated in cases where less alternative change of bacteria was seen.