E. Coliによる尿路感染症の細菌学的免疫学的研究

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59 cases with urinary tract infections were classified into four groups, non-obstructive upper urinary tract infections, non-obstructive lower urinary tract infections, obstructive upper urinary tract infections and obstructive lower urinary tract infections. A case with periurethral abcess was added to these patients. 68 strains of E. coli were isolated from urine specimens of these patients, a strain of E. coli from pus specimen and 141 strains of E. coli from fecal specimens were also isolated, and their serotypes (O and H), hemolytic abilities and drug sensitivities were tested. The antibody titers of patients sera against homologous E. coli were also investigated. These results were as follows ; 1) E. coli O4, O6 and O75 were frequently isolated from both urine and fecal specimens and these three O groups accounted for 52.2% of urinary and 17.8% of fecal E. coli. Each O group was subdivided into some serotypes by analyzing H antigen, namely O4 : H1, O4 : H5, O4 : H21, O4 : H49, O4 : HNT, O4 : H-, O6 : H1, O6 : H-, O75 : H5 and O75 : H-. 2) All strains, urinary and fecal, belonging to such serotypes as O4 : H1, O4 : H5, O4 : H-, O18 : H1, and O35 : H5 were hemolytic, and nearly all of O6 : H1 and O6 : H- were also hemolytic. But none of E. coli O75 was hemolytic. 3) All strains of E. coli O4 isolated from urine were found in patients with non-obstructive infections, but E. coli O6 and O75 were found both in non-obstructive and obstructive patients. Nearly all strains of urinary hemolytic E. coli were isolated from those patients with non-obstructive infections. 4) Those patients who carried one or more common O groups in their intestinal canals often suffered from urinary tract infections by one of those common O groups. 5) From these results and Yoshida's and Hara's report it was considered that the prevalence of common O groups in urinary tract could not be attributed only to the prevalence of those strains in reservoir, and some strains were more virulent in urinary tract. 6) The drug sensitivities of urinary E. coli were resembled to those of fecal E. coli in common O groups or hemolytic E. coli, but not so in infrequently isolated O groups or non-hemolytic E. coli. 7) In patients with upper urinary tract infections, non-obstructive and obstructive, the antibody titers against urinary E. coli were commonly high, particularly in those patients who had symptoms of acute pyelonephritis, most cases had high titers against infecting organisms. 8) No relation was seen between serotype, hemolytic ability and drug sensitivity pattern of one strain and antibody titer against that strain. 9) From these results it was considered that the antibody response was more influenced by site or tissure of infection rather than the character of infecting organism. Some discussions were also made about portal of entry and defensive effect of antibody.
社団法人日本泌尿器科学会の論文
1968-12-20

E. Coliによる尿路感染症の細菌学的免疫学的研究

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