Corynebacterium尿路感染症 : 症例報告と実験的検討

概要

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1)難治性の膀胱炎とアルカリ尿,struvite結石形成を示し,のちに膀胱直腸瘻をきたしたCorynebacteriumによる尿路感染症の1例を報告した.2)臨床分離株のCorynebacterium renaleを用い,in vitro, in vivoの尿アルカリ化作用,ラットstruvite結石形成実験を行い,C. renaleがP. mirabilisと同じように強力なウレアーゼ活性があり,結石形成作用があることを確認した.3) Corynebacteriumには多剤耐性で難治性の菌種があり,本菌による院内感染の可能性もあり,注意を喚起した.また感染結石の原因菌としての重要性を指摘したWe repose of chronic cystitis associated with alkali urine, struvite stones and a subsequent vesicorectal fistula caused by Corynebacterium sp, probably Corynebacterium group D2. We also studied in vitro and in vivo stone formation caused by Corynebacterium renale isolated clinically. C. renale inoculated into normal human urine increased urine pH and formed struvite crystals after a 24-hr incubation. Bladder stones were also formed in rats experimentally infected by C. renale as well as P. mirabilis. Some urea splitting species of Corynebacterium such as C. group D2 and C. renale may play a role in the formation of human struvite stone.