MUNUAISKIVET

[Bb]

Lähettäjä: Soijuv Lähetetty: 17.3.2006 13:59

Munuaiskivet ovat aika yleisiä mm. borrelioosia sairastavilla. Niiden syntyä edesauttaa mm. tiettyjen antibioottien käyttö sillä ne tuhoavat suolistosta tietyn bakteerin (oxalobakteeri formigenes). Kyseinen bakteeri estää munuaiskivien syntyä.

Munuaiskiviä saaville ei tule antaa kinoloneja sillä ne vähentävät suoliston oxalobakteeri formigenesin määrää. Parempi antaa penisilliiniä tai Bactrimia.



Intestinal Oxalobacter Formigenes Colonization Urinary Oxalate Levels in Calcium Oxalate Stone Formers

It is known that oxalobacter formigenes is a colonic bacterium capable of breaking intestinal oxalate. This study showed that there is a correlation between calcium oxalate stone formers and the absence of oxalobacter formigene colonization. Patients who form calcium oxalate stones, who lack oxalobacter have a higher average urinary oxalate level than patients who are oxalobacter positive. The authors suggest that patients taking quinolones will reduce the level of oxalobacter formigenes, while patients taking penicillin or Bactrim do not have any effect on the oxalobacter formigene level. They recommend giving penicillin or Bactrim to the patients who are calcium oxalate stone formers.

Troxel SA, Low RK. Intestinal Oxalobacter Formigenes Colonization Urinary Oxalate Levels in Calcium Oxalate Stone Formers. Journal of Urology 165:245A, 2001.

Can the Recurrence of Oxalate Stone be prevented? Role of Oxalobacter Formigenes in Stone Recurrence.

90% or urinary calculi are calcium oxalate stones. Oxalobacter formigenes is a oxalate degrading bacterium, colonizing the GI tract in humans. This study demonstrated a relationship between urinary oxalate levels and the intestinal bacterium, oxalobacter formigenes. The absence of the bacterium in the intestines appears to result in a higher risk of recurrent oxalate stone disease by causing hyperoxaluria.

Tunuguntla HSGR. Can the Recurrence of Oxalate Stone be prevented? Role of Oxalobacter Formigenes in Stone Recurrence. Journal of Urology 165:246A, 2001.

Journal of Endourology
Effect of Antibiotics on Oxalobacter formigenes Colonization of Human Gastrointestinal Tract
Jan 2005, Vol. 19, No. 1: 102-106


R.D. Mittal, Ph.D.
Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
R. Kumar, Ph.D.
Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
H.K. Bid, M.Sc.
Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
B. Mittal, Ph.D.
Department of Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Background and Purpose: Oxalobacter formigenes is a bacterium residing in the human gastrointestinal tract that degrades oxalate and reduces its availability for absorption. This bacterium is assumed to be antibiotic sensitive, and repeated antibiotic therapies could eradicate it. The aim of the present study was to determine the differences in the colonization by O. formigenes of individuals who had been on antibiotics for at least 5 days at the time of sample collection and individuals who had not taken antibiotics for at least 3 months.

Patients and Methods: Stool samples were collected from 80 individuals without stone disease (35 with and 45 without antibiotic consumption) and 100 patients with stone disease (20 with and 80 without antibiotic consumption). Oxalobacter formigenes was detected by a polymerase chain reaction-based method, and the presence/absence of O. formigenes was correlated with urinary oxalate concentrations.

Results: Lower percentages of individuals without stone disease and with stone disease who were consuming antibiotics had O. formigenes colonization than individuals without antibiotic consumption. Urinary oxalate concentrations were higher in the individuals without O. formigenes than in colonized individuals.

Conclusion: Our observations confirm a direct association between antibiotic consumption and absence of O. formigenes. Absence of intestinal O. formigenes could represent a pathogenic factor in calcium oxalate urolithiasis when antibiotics are prescribed generously.

This paper was cited by:
Kalciumoxalatharnsteine und Hyperoxalurie
M. Straub, R. E. Hautmann, A. Hesse, L. Rinnab
Der Urologe. 2005, Vol. 44, No. 11: 1315
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