Nicolle Lindsay E
Department of Internal Medicine, University of Manitoba, Health Sciences Centre, 820 Sherbrook Street, Room GG443, Winnipeg, MB R3A 1R9 Canada.
Infect Dis Clin North Am. 2003 Jun;17(2):367-94. doi: 10.1016/s0891-5520(03)00008-4.
Asymptomatic bacteriuria is common. Populations with structural or functional abnormalities of the genitourinary tract may have an exceedingly high prevalence of bacteriuria, but even healthy individuals frequently have positive urine cultures. Asymptomatic bacteriuria is seldom associated with adverse outcomes. Pregnant women and individuals who are to undergo traumatic genitourinary interventions are at risk for complications of bacteriuria and benefit from screening and treatment programs. Although screening is recommended for renal transplant recipients, the benefits for these patients are less clear. For other populations, including most bacteriuric individuals, negative outcomes attributable to asymptomatic bacteriuria have not been described. Treatment of asymptomatic bacteriuria in these patients is not beneficial and, in fact, may be associated with harmful outcomes, such as increased short-term frequency of symptomatic infection, adverse drug effects, and reinfection with organisms of increased antimicrobial resistance. Screening for asymptomatic bacteriuria and treatment is recommended for only selected groups where benefit has been shown. Many research questions still need to be addressed. Different populations have unique risk factors, and the benefits and risks of different management approaches for asymptomatic bacteriuria must continue to be addressed systematically in appropriate clinical trials.
无症状菌尿很常见。泌尿生殖道存在结构或功能异常的人群菌尿患病率可能极高，但即使是健康个体尿培养也常呈阳性。无症状菌尿很少与不良后果相关。孕妇以及即将接受创伤性泌尿生殖系统干预的个体有发生菌尿并发症的风险，筛查和治疗方案对其有益。虽然建议对肾移植受者进行筛查，但对这些患者的益处尚不太明确。对于其他人群，包括大多数菌尿患者，尚未描述无症状菌尿所致的不良后果。对这些患者进行无症状菌尿治疗并无益处，事实上，可能会带来有害后果，如短期内有症状感染的频率增加、药物不良反应以及感染对抗菌药物耐药性增加的病原体。仅对已证明有益的特定人群推荐进行无症状菌尿的筛查和治疗。许多研究问题仍有待解决。不同人群有独特的危险因素，无症状菌尿不同管理方法的益处和风险必须在适当的临床试验中继续系统地加以探讨。
