台北地區犬細菌性泌尿道感染之調查

Investigation of Canine Bacterial Urinary Tract Infection

張福台(Fu-Tai Chang)

指導教授 ： 杜杰憲

國立屏東科技大學/農學院/獸醫學系所/碩士(2010年)

https://doi.org/10.6346/NPUST.2010.00112

摘要

細菌性泌尿道感染 ( UTI ) 主要是由存在於皮膚和遠端泌尿生殖道的常在菌，經由尿道口上行感染所引起。本研究針對台北地區192頭臨床上被初步診斷為疑似泌尿道感染的犬隻，以膀胱穿刺法或導尿管 ( 僅使用於部份公犬 ) 採集其尿液檢體進行定量尿液培養，藥物敏感性試驗則以藥物稀釋法來測定抗菌劑對病原菌之最小抑制濃度 ( MIC )。定量尿液培養的結果100頭 ( 52.1％ ) 確診為泌尿道感染，其中4頭為同時出現兩種病原菌之混合感染。在這100頭陽性犬中公犬佔49頭，母犬佔51頭。引起泌尿道感染的主要病原菌有4種，佔總病原菌株 ( 104株 ) 的85.6％，依次為Escherichia coli ( 36.5％ )、Staphylococcus intermedius ( 25 ％ )、Proteus mirabilis ( 12.5％ )、Enterococcus faecalis ( 11.5％ )；其他佔比例較小的病原菌有Klebsiella pneumoniae、Pseudomonas aeruginosa、Enterobacter cloacae、Sphingomonas pseudosanguinis、Micrococus luteus、和Bacillus cereus。其中Sphingomonas pseudosanguinis為未曾在犬泌尿道感染症中被發現過的病原菌，其是否為變異菌株有待後續血清學和基因學的進一步研究。31種抗菌劑對病原菌的藥物敏感性試驗結果顯示，P. mirabilis為4種主要病原菌中最具抗藥性之菌種。目前被認為屬於最後防線的3種 ( 類 ) 抗菌劑vancomycin、carbapenems、和amikacin，在本研究中vancomycin對革蘭氏陽性菌Staphylococcus intermedius和Enterococcus faecalis具完美之抗菌活性；Imipenem則已有抗藥性Proteus mirabilis菌株出現，唯該菌株對meropenem仍具感受性；Amikacin對Proteus mirabilis之抗菌活性則明顯受限 ( R％＝38.5 ) 。在本研究中P. mirabilis對抗菌劑廣泛且多重的抗藥性，顯示其為極易產生抗藥性之菌種，與其它2種被認為極易產生抗藥性之革蘭氏陰性菌Pseudomonas aeruginosa和Enterobacter cloacae ( Prescott, 2002 ) 相較，有過之而無不及。

關鍵字

泌尿道感染 ； 尿液培養 ； 膀胱穿刺 ； 大腸桿菌

並列摘要

Almost all bacterial urinary tract infection ( UTI ) caused by ascending infection from skin and urogenital tract flora. We investigated 192 urine specimens from dogs diagnosed as having UTI in Taipei area. All specimens were obtained by cystocentesis or catheterization ( only performed in some male dogs ), and then were submitted to Clinical Pharmacology Laboratory, School of Veterinary Medicine, National Taiwan University for quantitative urine culture and antimicrobial susceptibility testing, which was performed by antimicrobial dilution method to determine the minimum inhibitory concentration ( MIC ) of the antimicrobials. Quantitative urine culture showed 100 dogs ( 52% ) were positive, in which 4 dogs were caused by two coinfecting uropathogens. The total bacterial isolates were 104 in this study. In the 100 dogs, 49 were male and 51 were female. The most prevalent uropathogens isolated from dogs having UTI were Escharichia coli ( 36.5% ), Staphylococus intermedius ( 25% ), Proteus mirabilis ( 12.5% ), Enterococcus faecalis ( 11.5% ). Small numbers of Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter cloacae, Sphingomonas pseudosanguinis, Micrococcus luteus, and Bacillus cereus were also isolated. Sphingomonas pseudosanguinis was firstly isolated from urine specimens of dogs having UTI according to the reports before. MICs of 31 antimicrobials showed Proteus mirabilis was the most antimicrobial-resitant bacteria of the four main uropathogens isolated from this study. About “last resort” antimicrobials ( amikacin, carbapenems, vancomycin ) in this study, vancomycin had perfect activity against Gram positive bacteria, Staphylococcus intermedeius and Enterococcus faecalis. Imipenem-resistant Proteus mirabilis strain had been isolated in this study, and meropenem still had good activity against this strain. Amikacin was less activity against Proteus mirabilis ( R %=38.5 ). In this study, multiresistant Proteus mirabilis was apparent. It showed Proteus mirabilis easily acquired resistance to the antimicrobials the same as the other Gram negative bactera like Pseudomonas aeruginosa and Enterobacter cloacae, which was known as innate antimicrobial-resistat bacteria.

並列關鍵字

urinary tract infection ； urine culture ； cystocentesis ； Escharichia coli

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