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[尿路感染与慢性肾衰竭]

[Urinary tract infections and chronic renal failure].

作者信息

Sobotová D

机构信息

II. interní klinika Lékarské fakulty MU a FN u sv. Anny v Brné.

出版信息

Vnitr Lek. 2011 Jul-Aug;57(7-8):626-30.

Abstract

The paper briefly summarizes issues related to urinary tract infections in adults: predispositions and risk factors, classification, assessment of pathogenicity of bacterial agents, the role of bacteriuria and leucocyturia, interpretation of findings, treatment principles and an association with chronic renal failure. Urinary tract infections are the second most frequent infectious disease in the population. They most often affect women of childbearing potential and then seniors of both sexes who have multiple risk factors. Escherichia coli and Staphylococcus saprophyticus are the most pathogenic towards urinary tract; they are responsible for 85% and 10-15% of cases of acute uncomplicated urinary infections, respectively. Chronic pyelonephritis, a chronic interstitial nephritis, is the fourth most frequent cause of chronic renal failure. Chronic renal failure is a risk factor for the development of urinary infections due to metabolic disorders resulting in secondary immunodeficiencywith a disorder of all components of immunity. In patients with chronic renal failure, urinary tract infections occur most frequently after kidney transplantation when graft pyelonephritis is a life-threatening complication. Therefore, urinary tract infection prevention with co-trimoxazole once daily over at least 6 months is recommended in renal allograft recipients.

摘要

本文简要总结了与成人尿路感染相关的问题

易患因素和风险因素、分类、细菌病原体致病性评估、菌尿和白细胞尿的作用、检查结果解读、治疗原则以及与慢性肾衰竭的关联。尿路感染是人群中第二常见的传染病。它们最常影响具有生育潜力的女性,然后是具有多种风险因素的老年男女。大肠埃希菌和腐生葡萄球菌对尿路致病性最强;它们分别导致85%和10 - 15%的急性单纯性尿路感染病例。慢性肾盂肾炎,一种慢性间质性肾炎,是慢性肾衰竭的第四大常见病因。慢性肾衰竭是尿路感染发生的一个风险因素,因为代谢紊乱导致继发性免疫缺陷,累及免疫的所有成分。在慢性肾衰竭患者中,尿路感染最常发生在肾移植后,此时移植肾肾盂肾炎是一种危及生命的并发症。因此,建议肾移植受者每天一次服用复方新诺明预防尿路感染,持续至少6个月。

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