Detection Of IBCs In Patients With Urinary Tract Infection And Characteristics Of TCM Syndromes

BackgroundUrinary tract infection(UTI)caused by urinary tract pathogens invading the urethra affects more than 100 million people worldwide.China’s urinary tract infections account for 20.8%to 31.7%of the total number of patients with nosocomial infections,and their incidence is only second to respiratory infections.The second place in infectious diseases.At the same time,a large number of investigations have shown that due to the urinary tract pathogenic Escherichia coli(UPEC)retention in the host bladder epithelial cells,and the formation of drug resistance and immune escape mechanisms lead to recurrent urinary tract infections,for the majority of women health and medical care The cost has caused a heavy burden.At present,the main means of diagnosing urinary tract infection still depends on the results of urine culture.This method has problems such as long time-consuming and low positive rate.Therefore,the screening of rapid,sensitive and accurate diagnostic markers has become the trend of clinical diagnosis and treatment of urinary tract infections.ObjectivesTo establish a rapid detection method for colony and filamentous bacteria in urine epithelial cells,and compare with the existing urine and urine culture methods to evaluate the sensitivity and specificity of the method,and to explore the clinical significance of IBCs and filamentous bacteria as UTI.The feasibility of the diagnosis or prognosis identification,and finally establish the clinical diagnosis of UPEC rapid diagnosis and prognosis.On this basis,the correlation between TCM syndromes,clinical symptoms and the formation of IBCs and UTI recurrence was analyzed,and the principles of TCM treatment for TCM to delay the recurrence of urinary tract infection were providedMethodsIn this study,32 patients with initial and recurrent urinary tract infections who met the inclusion criteria were enrolled in the study.Sixteen healthy volunteers were selected as controls.Fresh and clean mid-stage urine samples were collected,and urine IBCs and filamentous bacteria were identified under light microscope in the acute infection period and one week after the end of treatment,and compared with the conventional detection methods for urine routine and urine culture to determine the identification methods of IBCs and filamentous bacteria.The specificity and sensitivity were evaluated as viable for determining UTI diagnostic or prognostic markers.On this basis,the characteristics of TCM syndromes were analyzed,and the recurrence of the two groups of patients was followed up for 6 months.The correlation between TCM syndromes and clinical symptoms and the formation of IBCs and UTI recurrence were analyzed.This study used statistical software SPSS 10.0 for data processing and related statistical analysis.Results1 General information comparisonThe majority of patients with RUTI were concentrated in postmenopausal women aged 55-70 years.The ages of UTI group and healthy volunteer group were scattered in all age groups.The age difference of the three groups was statistically significant(P<0.05).The patients in the UTI group and the RUTI group had a longer course than the UTI group.The difference was statistically significant(P<0.05).2 Identification of IBCs and filamentous bacteriaIn the UTI group,the RUTI group,and the healthy volunteer group,the fresh mid-stage urine samples were treated with centrifugation and Giemsa staining,and IBCs were found in the urine samples of most RUTI patients and UTI patients under light microscope.For the accumulation of irregular brittle dark blue objects,there are burrs and protrusions on the sides.At high magnification,the accumulation of filamentous bacteria can be seen around some IBCs.There was no aggregation of agglomerated dark blue stained objects under the light microscope in the urine of healthy volunteers.3 IBCs specific evaluationThe positive rates of filamentous bacteria and IBCs in the RUTI group before and after treatment were significantly higher than those in the UTI group,and P<0.01,with statistically significant differences.After binary logistic regression analysis,IBCs and filamentous bacteria were used as independent variables,and recurrence was the dependent variable.The results suggest that IBCs are risk factors for UTI recurrence(P=0.023,OR=16.50),while filamentous bacteria and recurrence are not.There was a correlation(P>0.05).At the same time,the patients with filamentous bacteria positive after treatment have different degrees of negative conversion,while the IBCs positive patients have no change before and after treatment,which is consistent with the clinical situation of RUTI patients with unhealed and recurrent episodes,suggesting that IBCs are The RUTI patient-specific diagnostic marker can be used as a UTI prognostic indicator.4 IBCs sensitivity evaluationThe results of this study suggest that 25 cases(39.1%)were positive for IBCs in acute infection,and 100%positive in urine and urine culture.The positive rate of IBCs was significantly lower than that in urine and urine culture,and P<0.0001.The difference was extremely significant.Statistical significance.However,after 21 days,there was a significant negative change in urine routine and urine culture.However,the results of IBCs-positive patients failed to turn negative,and the positive rate did not change before and after treatment.The positive rate of IBCs(39.1%)was significantly higher than that of urine(12.5%),and the difference was statistically significant(P<0.0001).The positive rate of IBCs(39.1%)was significantly higher than that of urine culture(4.7%).The difference was statistically significant(P<0.0001).The high positive rate of IBCs in patients with urinary tract infection after treatment suggests that there is bacterial colonization in the urothelium of patients with urinary tract infection.Therefore,the prognosis of patients with urinary tract infection is better than that of urine routine and urine culture.The possibility of an attack.5 Specificity of filamentous bacteriaIn the acute infection period,23 cases(35.9%)were positive for filamentous bacteria.Although they did not reach the urine culture and urine routine 100%positive rate,the positive results of urine and urine culture were also positive.Twenty-three patients with positive filamentous bacteria and urine routines turned negative in 16 cases after 21 days.Among them,15 cases of filamentous bacteria and urine routine turned negative,1 case of urinary routine turned negative,filamentous bacteria did not turn negative,visible silk The urinary routine results of patients with negative bacteria turned negative.Twenty-three patients with filamentous bacteria and urine culture were positive in 20 cases,and 20 cases of urine culture turned negative.Among them,15 cases of filamentous bacteria and urine cultures turned negative,5 cases of urine culture turned negative,filamentous bacteria did not turn negative,visible silk The urine culture results of patients with negative bacteria turned negative.Therefore,it is suggested that filamentous bacteria can be used as a marker for the acute attack of urinary tract infection,and has certain specificity,but its sensitivity is far insufficient compared with urine routine and urine culture.6 TCM Syndrome Characteristics and Correlation StudyThe frequency of damp-heat syndrome in patients with urinary tract infection was the highest in 35 cases(54.69%).In terms of TCM symptoms,the top three were urinary yellow or turbid(82.81%)and urethral burning sting(71.88%),frequent urinary frequency(68.75%);tongue color has the highest frequency of red tongue,reaching 65.63%;tongue is pale and the incidence of tooth marks is relatively high,both exceeding 25%;thin yellow moss appears on the tongue The frequency is the highest,reaching 35.94%;the pulse with higher frequency in the pulse is more than 40%of the pulse,slippery pulse,slippery pulse and fine vein.Correlation analysis between TCM syndromes and IBCs suggests that there is a correlation between damp-heat syndrome and the formation of IBCs(P=0.008,OR≈4.55).Therefore,it can be inferred that the risk of developing IBCs in the bladder urinary tract of UWI patients is 4.55 times higher than that of non-damp heat syndrome UTI patients.Correlation analysis between TCM syndrome type and urinary tract infection recurrence suggests that damp-heat syndrome is associated with UTI recurrence(P=0.039,OR≈2.96),suggesting that the risk of recurrence of urinary tract infection in patients with damp-heat syndrome is 2.96 times that of non-damp heat syndrome.Correlation analysis between TCM symptoms and IBCs showed frequent urinary frequency(P<0.05,OR≈1.50),incidence(P<0.05,OR≈2.53),oral bitterness(P<0.05,OR≈1.49)and bladder There is a correlation between the formation of urinary tract IBCs.Among them,the frequency of urinary urgency is short,and the bitterness and mouth-to-mouth adhesion belong to the category of damp-heat syndrome.Correlation analysis between TCM symptoms and UTI recurrence showed urinary burning tingling(P<0.05,OR≈2.38),oral bitterness(P<0.05,OR≈5.72),and labor(P<0.05,OR≈2.77)There is a recurrence of urinary tract infections.Among them,the urinary tract burning tingling and the bitter mouth and mouth are all in the category of dampness and heat syndrome;in case of labor,it belongs to the category of yang deficiency syndrome.ConclusionThis study suggests that IBCs are diagnostic markers specific to urine specimens in patients with RUTI.As a prognostic indicator for patients with urinary tract infections,the sensitivity is superior to traditional detection methods for urine routine and urine culture.At the same time,IBCs are associated with recurrent urinary tract infections and are independent risk factors for recurrence of urinary tract infections.Filamentous bacteria can be used as a marker for the acute attack of urinary tract infections,with certain specificity but insufficient sensitivity.Correlation study of TCM syndrome characteristics suggests that damp-heat syndrome is associated with the formation of bladder urothelial IBCs and the recurrence of urinary tract infections.There are three clinical symptoms in the clinical symptoms,such as urinary urgency and shortness of mouth,bitter and sticky,and the occurrence of IBCs.The urinary tract is hot,stinging,bitter,sticky,and three clinical symptoms and recurrence of urinary tract infection.There is correlation.Frequent urinary urgency,urinary tract tingling,mouth bitterness and stickiness belong to the category of damp-heat syndrome,and it is a category of yang deficiency syndrome.Therefore,in the clinical evidence,we should pay attention to the important role of the treatment principles of "heat-clearing and dampness" and"tonic deficiency" in preventing and treating the recurrence of urinary tract infection.