Wayne State University School of Medicine, Detroit Receiving Hospital, 5S-10, 4201 St. Antoine, Detroit, MI, 48201, USA,
Curr Infect Dis Rep. 2010 Nov;12(6):450-4. doi: 10.1007/s11908-010-0141-0.
Nephrolithiasis is a common clinical entity, and the incidence of renal stones appears to be increasing in the United States. Infection with uropathogens that produce urease can lead to the development of stones (infection stones), which serve as a continued source of recurrent infection and can lead to chronic kidney disease. Other than treating infection, medical management has little role in the treatment of infection stones; complete eradication of the stones with percutaneous nephrolithotomy or extracorporeal shock wave lithotripsy is required. Stones of metabolic origin can cause obstruction in the ureter and predispose to the development of urinary tract infection (UTI). Recognizing obstruction and initiating prompt drainage of the collecting system is important in the successful management of nephrolithiasis complicated by UTI. These patients are often at high risk of infection with an antimicrobial-resistant pathogen, so careful consideration of antimicrobial therapy is required, especially for patients who present with severe sepsis.
肾结石是一种常见的临床病症，在美国，肾结石的发病率似乎呈上升趋势。产生脲酶的尿路病原体感染可导致结石（感染性结石）的形成，这成为反复感染的持续来源，并可导致慢性肾脏病。除了治疗感染外，医学治疗在感染性结石的治疗中作用不大；需要经皮肾镜碎石术或体外冲击波碎石术彻底清除结石。代谢性结石可引起输尿管梗阻，并易导致尿路感染（UTI）的发生。在成功治疗伴有 UTI 的肾结石时，识别梗阻并及时引流集合系统非常重要。这些患者通常存在感染耐药病原体的高风险，因此需要仔细考虑抗菌治疗，尤其是对于出现严重脓毒症的患者。
