Wilson Michael L, Gaido Loretta
Department of Pathology and Laboratory Services, Denver Health Medical Center, University of Colorado School of Medicine, Denver, Colorado 80204-4507, USA.
Clin Infect Dis. 2004 Apr 15;38(8):1150-8. doi: 10.1086/383029. Epub 2004 Apr 6.
Urinary tract infections (UTIs) are among the most common bacterial infections and account for a significant part of the workload in clinical microbiology laboratories. Enteric bacteria (in particular, Escherichia coli) remain the most frequent cause of UTIs, although the distribution of pathogens that cause UTIs is changing. More important is the increase in resistance to some antimicrobial agents, particularly the resistance to trimethoprim-sulfamethoxazole seen in E. coli. Physicians distinguish UTIs from other diseases that have similar clinical presentations with use of a small number of tests, none of which, if used individually, have adequate sensitivity and specificity. Among the diagnostic tests, urinalysis is useful mainly for excluding bacteriuria. Urine culture may not be necessary as part of the evaluation of outpatients with uncomplicated UTIs, but it is necessary for outpatients who have recurrent UTIs, experience treatment failures, or have complicated UTIs, as well as for inpatients who develop UTIs.
尿路感染（UTIs）是最常见的细菌感染之一，在临床微生物学实验室的工作量中占很大一部分。肠道细菌（特别是大肠杆菌）仍然是尿路感染最常见的病因，尽管引起尿路感染的病原体分布正在发生变化。更重要的是对某些抗菌药物的耐药性增加，尤其是大肠杆菌对甲氧苄啶-磺胺甲恶唑的耐药性。医生通过使用少量检查将尿路感染与其他临床表现相似的疾病区分开来，但如果单独使用，这些检查均没有足够的敏感性和特异性。在诊断检查中，尿液分析主要用于排除菌尿。对于无并发症的尿路感染门诊患者，尿液培养可能不是评估的必要部分，但对于复发性尿路感染、治疗失败或有复杂性尿路感染的门诊患者以及发生尿路感染的住院患者，尿液培养是必要的。
