Enterococcus faecalisが関与していると思われる腎盂腎炎の臨床的検討

Abstract

1)E.faecalisによる難治性腎盂腎炎の臨床的検討を行い, 治療上の問題点を指摘した. 2)難治性腎盂腎炎の起炎菌となりえるE.faecalisの腎への親和性, 病原性は決して低いとはいえない. 3)治療法については臨床症状と菌の消長を考慮し慎重に選択する必要がある

A clinical study was performed in 13 cases of refractory Enterococcus faecalis pyelonephritis that were detected in the Department of Urology, Hiratsuka Municipal Hospital, from April 1975 to March 1995. The characteristic features were that pyelonephritis was commonly seen in females, and clinical symptoms (low-grade intermittent fever, low back pain, general malaise, etc.) were continuously refractory. Bacteriuria or polymicrobial infections were often found, and bacterial count was often as high as 10(2)-10(4)/ml. Nevertheless we considered that E. faecalis caused of refractory pyelonephritis must not have week adherence and pathogenesis to the kidney, owing to the clinical symptoms and the basic subjects. Furthermore this infection was difficult to cure completely with antimicrobials having activity against E. faecalis, and long-term treatment was needed. Therefore, we recommend that treatment for refractory E. faecalis pyelonephritis be carefully selected according to clinical symptoms and the bacterial density of this strain.