真菌性尿路感染症の臨床的考察

Abstract

最近2年間の真菌性尿路感染症20例を集計し, 頻度, 菌種, 基礎疾患および誘因, 細菌感染との関係, 治療および結果につき調べた.1)頻度は入院患者総数の約5%で, 年齢のかたよりはなく, 男女比は12:8であった.2)感染部位は膀胱炎13例, 腎盂腎炎5例, 回腸導管2例であった.3)菌種はCandida albicansがもっとも多く, ついでTorulopsis glabrata, Gandida tropicalisであった.4)基礎疾患および誘因では抗生剤使用, 留置カテーテル, 尿路通過障害, 糖尿病, ステロイド投与などであった.5)真菌と細菌との共存は一部の例でみられたが, Pseudomonas, Proteusなどの尿素分解細菌との共存はみられなかった.6)治療は重ソウ投与, 5-fluorocytosine, amphotericin Bの尿路洗浄などで, 治療成績はおおむね良好であった

We analyzed 20 cases of urinary fungal infection experienced at our Department, during the last 2 years. Candida albicans was the most prevalent of the fungi affecting the urinary tract. Torulopsis glabrata and Candida tropicalis were also prevalent. Antibiotics, indwelling catheter and obstructive uropathy were the most prevalent predisposing factors of the fungal infection. Of 20 cases of fungal infection, 5 cases were cured only by elimination of the predisposing factors, and 15 cases were treated and resolved by administration of sodium bicarbonate, 5-fluorocytosine and or irrigation with amphotericin B. But one case of bilateral renal torulopsiosis developed into renal failure, and 4 cases died of the primary disease.