目的分析输尿管支架管表面细菌生物被膜的病原学分布特点,探讨细菌生物被膜对抗菌药物的耐药性。方法收集2008年10月-2012年1月281例患者放置输尿管支架管送检标本,每份标本分为肾盂内段,输尿管段及膀胱内段、并收集膀胱内尿液,用刚果红培养基筛选出每段支架管生物被膜菌株,对尿液进行细菌培养,对检出的病原菌进行药敏试验分析。结果281例输尿管支架管患者标本中检出生物被膜菌220株,检出阳性率为78.3%;其中膀胱内段阳性率86.4%,输尿管段44.5%,肾盂内段66.4%,膀胱内尿液细菌培养阳性率33.6%;病原菌以大肠埃希菌为主,在各段检出率均〉50.0%,其次为铜绿假单胞菌、鲍氏不动杆菌;输尿管支架管生物被膜菌具有很高的耐药率。结论输尿管支架管细菌生物被膜菌株检出率明届高于尿液细菌培养,细菌寄殖和生物被膜形成是泌尿系感染的重要发病因素,早期检测生物被膜菌具有重要意义。
OBJECTIVE To analyze the features of pathogenic distribution of bacterial biofilm on ureteral stent tube, and to discuss the drug resistance to antimicrobial drugs of bacterial biofilm. METHODS The submitted specimens of ureteral stent tubes placed in 281 patients were collected in our hospital during the period of Oct. 2008 and Jan. 2012. Each specimen was separated into three parts (renal pelvis, ureter and bladder), the urine in bladder was collected. The biofilm-forming bacteria strains were isolated by Congo red medium. The urine was bacterial cultured. The drug susceptibility tests were done with the collected biofilm-forming bacteria strains. RESULTS In 281 specimens of ureteral stent tubes, 220 (78.3%) bacterial biofilms were detected, and the positive rate was 78.3%, which included 86.4% in bladder part,44.5% in ureter part and 66.4% in renal pelvis part. The positive rate of urine culture in the bladder was 33.6%. Escherichia Coli was the main bacteria with a detection rate of over 50.0% in all parts, and the secondary were Pseudomonas aeruginosa, Acinetobacter baumannii. The biofilm- forming bacteria on the ureteral stent tube had a very high drug resistance. CONCLUSION The strain detection rate in the bacteria biofilm on ureteral stent tube is significantly higher than that in the urine bacteria culture. The bacteria generated and biofilm formed in the ureteral stent tubes are important reasons for urinary tract infections. Early detection of biofilm-forming bacteria strains is very important.