Microbiologic Aerobic Studies On Urethra In Patients With Anterior Urethral Stricture

OBJECTIVE To explore the reason for high incidence of infection of urethra after operation and the countermeasures to reduce infection rate.METHODS The clinical data of 62 anterior urethral stricture patients undergoing surgical treatment from July 2014 to April 2017 were analyzed,then samples from urine,material for urethral reconstruction,urethra orifice and urethra were collected respectively.The bacterial culture,identification and pulsed field gel electrophoresis(PFGE)was performed.All the patients were males,and the mean age was 35.6 years(ranging 10~68 years).Operation methods were urethroplasty using oral mucosa in 21 cases,urethroplasty using penile flap in 23 cases,urethroplasty using scrotal flap in 5 cases,urethroplasty using penile flap combined with oral mucosa in 9 cases,urethroplasty using penile flap combined with scrotal flap in 3 cases and urethroplasty using preputial flap in 1 case.RESULTS There were 20 strains of bacteria detected in the urethra before operation,including 12 strains of Staphylococcus epidermidis,3 strains of Staphylococcus aureus,2 strains of Enterococcus avium,1 strain of Chryseobacterium indologenes,1 strain of Citrobacter koseri and 1 strain of Acinetobacter lwoffi,among which 15 cases were gram positive cocci.There were 49 strains of bacteria detected in the urethra after operation,including 12 strains of Staphylococcus epidermidis,9 strains of Staphylococcus aureus,7 strains of Enterococcus faecalis,5 strains of Escherichia coli,4 strains of Enterobacter cloacae,3 strains of Acinetobacter lwoffi,3 strains of Enterobacter aerogen,2 strains of Enterococcus faecium,2 strains of Klebsiella pneumonia,1 strain of Acinetobacter Bauman and 1 strain of Pseudomonas aeruginosa,among which 30 cases were gram positive cocci.The bacteria isolated from urethra orifice after operation were consistent with bacteria isolated from the neourethral lumen in 41 cases.The bacteria isolated from material for urethral reconstruction were consistent with bacteria isolated from the neourethral lumen in 18 cases.The bacteria isolated from preoperative urethral lumen were consistent with bacteria isolated from the neourethral lumen in 7 cases.Bacteria were not detected in the neourethral lumen in 13 cases.The bacteria isolated from urine were consistent with bacteria isolated from the neourethral lumen in 3 cases.CONCLUSIONS The bacteria in the neourethra mainly come from urethra orifice.Urine is not the main source for bacteria in neourethra.Perioperative intervention for sources of bacteria in neourethra is an effective measure to improve the success rate of operation.