输尿管支架细菌生物膜观察及病原菌分布和耐药性

402160)
DOI:10.3969/j.issn.2095-4344.2267
ORCID: 0000-0001-9204-7321(1)研究发现输尿管支架表面细菌生物膜的形成在导管相关性尿路感染中起着重要作用，细菌黏附在 输尿管支架形成生物膜后具有很强的耐药性；
(2)全面分析输尿管支架表面细菌生物膜的形态学特点、病原菌费分布和耐药性。
Zhang Jiamo, Master, Attending physician, Department of Urology, Yongchuan Hospital, Chongqing Medical University, Chongqing 402160, China
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ZHANG JM, ZHANG X, LUO HM, ZHAO T, CHEN JC, LIU J, WANG K. Pathogenic distribution and drug resistance of bacterial biofilm on ureteral stent. Zhongguo Zuzhi Gongcheng Yanjiu. 2020;24(16):2556-2560. DOI:10.3969/j.issn.2095-4344.2267
Abstract BACKGROUND: Ureteral stents have been extensively applied in the stenosis in the conjunction of the renal pelvis and ureter, the reconstruction of in situ urine flow, ureter or nephroscope lithotripsy, renal transplant, and tumors. However, the long-term retention of ureteral stents can induce catheter-associated urinary tract infection complications. OBJECTIVE: To investigate the morphological characteristics of bacterial biofilm on ureteral stent, and to analyze the features of pathogenic distribution and antimicrobial drug resistance to bacterial biofilm. METHODS: Specimens of ureteral stent were collected from 127 patients at Yongchuan Hospital, Chongqing Medical University between January and December 2016. The morphological characteristics of bacterial biofilm on the stent were observed under scanning electron microscope. Each specimen was divided into three parts (renal pelvis, ureter and bladder) for screening biofilm-forming bacteria strains separately by Congo red medium. The urine was bacterially cultured. Drug susceptibility test was done with the collected biofilm-forming bacteria strains. The study was approved by the Ethics Committee of Yongchuan Hospital, Chongqing Medical University (approval No. 201422). RESULTS AND CONCLUSION: (1) Bacterial biofilm was observed on the surface of ureteral stents at 7, 15 and 30 days of retention, with various numbers of inflammatory attachments or crystals. Bacteria on the bacterial biofilm were embraced by large amounts of fiber membranes. Patchy bacterial colonies were observed on the surface of the ureteral stent at 7 and 15 days of retention, which mainly focused on bacillus. Heap-shaped bacterial colonies were found on the surface of ureteral stents that were retained for 30 days, which mainly were bacillus and coccus. (2) A total of 106 bacterial biofilms were detected in the ureteral stent samples obtained from 127 patients. The positive rate was 83.5%, in which the bladder section had the highest positive rate, followed by the renal pelvis section and ureter section. There were 25 copies of positive urine culture, and the positive rate was 19.7%. The strains obtained from the bacterial biofilm on each section of the ureteral stents were significantly higher than that from the urine bacteria culture (P < 0.05). (3) A total of 227 strains were detected from 106 positive samples. Among these samples, the number of Gram-negative strains was significantly higher than that of Gram-positive strains (P < 0.05). Among culture bacteria of the bacterial biofilm on the ureteral stent and urine culture bacteria, colibacillus, pseudomonas aeruginosa, enterococcus faecalis and enterococcus faecium were the most common. (4) The biofilm-forming bacteria on the ureteral stent had a high drug resistance. (5) In summary, bacterial biofilm may be the important reason for catheter-associated urinary tract infection. Key words: bacterial biofilm; ureteral stent; catheter-associated urinary tract infection; drug resistance; nosocomial infections; urine culture; colibacillus; pseudomonas aeruginosa Funding: the Medical Research Project of Health and Family Planning Commission of Chongqing, No. 20142062 (to ZJM)
Pathogenic distribution and drug resistance of bacterial biofilm on ureteral stent
Zhang Jiamo1, Zhang Xuan1, Luo Huaming1, Zhao Tao1, Chen Jiangchuan1, Liu Juan2, Wang Ke3 (1Department of Urology, 2Department of Pharmacy, 3Department of Laboratory Medicine, Yongchuan Hospital, Chongqing Medical University, Chongqing 402160, China)
扫描电镜：
结论：
获取 127 例 患者的输尿 管支架标本
观察支架表面细菌生物膜的形态学特征； 刚果红培养基：
筛选肾盂段、输尿管段和膀胱段支架的细 菌生物膜菌株；
输尿管支架细菌 生物膜是诱发导 管相关性尿路感 染的重要因素。
尿培养：
对检出的病原菌进行药敏试验分析。
张家模，男，1982 年生， 重庆市人，汉族，硕士， 主治医师，主要从事泌尿 系结石微创治疗方面的研 究。
《中国组织工程研究》 Chinese Journal of Tissue Engineering Research