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Current insights into the mechanisms and management of infection stones
Nature Reviews Urology ( IF 12.1 ) Pub Date : 2018-11-23 , DOI: 10.1038/s41585-018-0120-z
Erika J. Espinosa-Ortiz , Brian H. Eisner , Dirk Lange , Robin Gerlach

Infection stones are complex aggregates of crystals amalgamated in an organic matrix that are strictly associated with urinary tract infections. The management of patients who form infection stones is challenging owing to the complexity of the calculi and high recurrence rates. The formation of infection stones is a multifactorial process that can be driven by urine chemistry, the urine microenvironment, the presence of modulator substances in urine, associations with bacteria, and the development of biofilms. Despite decades of investigation, the mechanisms of infection stone formation are still poorly understood. A mechanistic understanding of the formation and growth of infection stones — including the role of organics in the stone matrix, microorganisms, and biofilms in stone formation and their effect on stone characteristics — and the medical implications of these insights might be crucial for the development of improved treatments. Tools and approaches used in various disciplines (for example, engineering, chemistry, mineralogy, and microbiology) can be applied to further understand the microorganism–mineral interactions that lead to infection stone formation. Thus, the use of integrated multidisciplinary approaches is imperative to improve the diagnosis, prevention, and treatment of infection stones.



中文翻译:

对感染性结石的机制和治疗的最新见解

感染结石是在有机基质中融合在一起的复杂晶体聚集体,与尿路感染严格相关。由于结石的复杂性和高复发率,形成感染结石的患者的治疗具有挑战性。感染结石的形成是一个多因素过程,可由尿液化学作用,尿液微环境,尿液中存在调节剂物质,与细菌的缔合以及生物膜的形成来驱动。尽管进行了数十年的研究,但对感染结石形成的机制仍知之甚少。对感染性结石形成和生长的机械理解-包括有机物在结石基质,微生物,结石中的生物膜和生物膜及其对结石特征的影响-这些见解的医学含义对于开发改进的治疗方法可能至关重要。可以应用各种学科(例如,工程,化学,矿物学和微生物学)中使用的工具和方法来进一步了解导致感染石形成的微生物与矿物质的相互作用。因此,必须采用综合的多学科方法来改善感染石的诊断,预防和治疗。和微生物学)可用于进一步了解导致感染结石形成的微生物与矿物质的相互作用。因此,必须采用综合的多学科方法来改善感染石的诊断,预防和治疗。和微生物学)可用于进一步了解导致感染结石形成的微生物与矿物质的相互作用。因此,必须采用综合的多学科方法来改善感染石的诊断,预防和治疗。

更新日期:2019-01-26
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