尿路感染症の臨床的研究 : 急性膀胱炎のさいの上部尿路の関連
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The influence of apparently uncomplicated, acute, bacterial cystitis on the upper urinary tract was investigated by location-of-infection studies, which were accomplished by examination of the ureteric urine specimens collected through ureteric catheterization after preliminary irrigation of the bladder, as reported by Stamey et al. (1965). Specimens of the ureteric urine were collected from 33 patients (32 females and one male) with acute bacterial cystitis. The samples of bladder urine revealed significant bacteriuria with bacterial counts of more than 10^5 per ml. Of the 33 cases, the species of the isolated organisms were Escherichia coli in 30 cases, Staphylococcus aureus in 2 cases and Streptococcus faecalis in one case. The cultivation of the ureteric urine specimens revealed a positive culture in 8 (24.2%) of 33 cases. Bacterial counts in the ureteric urine were proved to be significantly higher than those in the bladder wash. The species of the organisms which were cultured in the ureteric urine were identical with those in the blad der urine (E. coli in 7 cases and Streptococcus faecalis in one case). Serum antibody titres against E. coli O were also determined by the bacterial agglutination technique. Clinical symptomes, signs and laboratory data in the group of positive ureteric urine culture were compared with those in the group of negative cultures. As a rule, pyrexia and leucocytosis were more marked in the former group, but there was no definitive finding which could be useful in differentiating these two groups. Serum antibody titres were generally high in the group of positive cultures. The osmolarity of the uterteric urine was proved to be low on the infected side, when compared with the uninvolved side. These results indicated that patients with acute cystitis, though apparently uncomplicated, might have the upper urinary tract involvement, and that these patients should be carefully treated with antibiotics and/or chemotherapeutics.
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