Medical College Hospitals, Main Clinical Campus, Department of Medicine, Division of Infectious Diseases, 3300 Henry Avenue, Philadelphia, PA 19129, USA.
Int J Antimicrob Agents. 1994 Jun;4(2):101-6. doi: 10.1016/0924-8579(94)90041-8.
Defects in the immune system determine the clinical manifestations and severity of urinary tract infections (UTI) and the rates of complication but they only have an indirect role in influencing susceptibility to infection. The rates of UTI in diabetics, renal transplant, recipients, neutropenic patients, and patients with AIDS are primarily determined by the degree and duration of urinary tract manipulation and the higher perineal prevalence of potential pathogens that result from frequent hospitalization and antimicrobial use. Prompt recognition and treatment of established infections is critical to prevent life-threatening complications (e.g. bacteremia, emphysematous pyelonephritis) but routine screening for asymptomatic bacteriuria is indicated only in kidney recipients less that 3 months post-transplantation.
免疫系统缺陷决定了尿路感染(UTI)的临床表现和严重程度以及并发症的发生率,但它们仅在间接影响感染易感性方面发挥作用。糖尿病患者、肾移植受者、中性粒细胞减少症患者和艾滋病患者的 UTI 发生率主要取决于尿路操作的程度和持续时间,以及由于频繁住院和使用抗菌药物导致的潜在病原体在会阴部更普遍存在。及时识别和治疗已确立的感染对于预防威胁生命的并发症(如菌血症、气肿性肾盂肾炎)至关重要,但仅在肾移植后 3 个月内的肾移植受者中才需要对无症状菌尿进行常规筛查。