The Journal of Medical Microbiology, Vol 16, Issue 2 221-226, Copyright © 1983 by Society for General Microbiology
The urinary bacterial flora in patients with three types of urinary tract diversion
M. J. Hill, M. J. Hudson and M. Stewart
There is known to be a high risk of malignancy at uretero-colic anastomoses
and it has been postulated that bacteria catalyse both the local formation
and the activation of carcinogens such as N-nitrosamines. If this theory is
correct, then the risk of malignancy should be greatest when the prevalence
of mixed urinary tract infection is greatest. Bacterial culture was
performed on samples of urine obtained from 56 patients with three forms of
urinary tract diversion: ureterosigmoidostomy, isolated ileal and colon
conduits. As expected, the rectal urine of all patients with a
ureterosigmoidostomy had a rich bacterial flora. However, 11 of the 15
patients with ileal conduits (73%) had significant mixed growths of
bacteria in the loop urine, whereas only six out of 16 colon loop urines
(37.5%) were infected, all being monobacterial infections. The implications
of these bacteriological findings for carcinogenesis associated with
urinary diversion are discussed.
