Department of Internal Medicine and Medical Microbiology, University of Manitoba, Health Sciences Centre, Room GG443-820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada,
Curr Infect Dis Rep. 2011 Dec;13(6):552-60. doi: 10.1007/s11908-011-0212-x.
Urinary tract infection remains a common problem for many populations. Recent studies have expanded our understanding of the host innate immune response and its role in the familial association observed for recurrent uncomplicated urinary tract infection in healthy women. Therapeutic management for uncomplicated infection has been compromised by increasing antimicrobial resistance, particularly global dissemination of the CTXM-15 extended spectrum β-lactamase (ESBL) producing Escherichia coli ST-131 strain. Prevention strategies exploring non-antimicrobial approaches continue to show limited promise, and approaches to limit empiric antimicrobials are now being explored. For complicated urinary tract infection, increasing antimicrobial resistance limits therapeutic options for many patients. In addition to ESBL producing E. coli, NDM-1 E. coli and Klebsiella pneumoniae and other resistant Gram negatives, such as Acinetobacter species, are being isolated more frequently. There has been renewed interest in catheter-acquired urinary tract infection, the most common health-care associated infection, with several recent evidence-based guidelines for infection prevention available. However, technologic progress in development of adherence-resistant catheter materials remains disappointing.
尿路感染仍然是许多人群的常见问题。最近的研究扩展了我们对宿主固有免疫反应的理解及其在健康女性复发性单纯性尿路感染家族关联中的作用。由于抗菌药物耐药性的增加，特别是 CTXM-15 扩展谱β-内酰胺酶（ESBL）产生的大肠埃希菌 ST-131 株在全球的传播，单纯性感染的治疗管理受到了影响。探索非抗菌方法的预防策略仍然显示出有限的希望，现在正在探索限制经验性抗菌药物的方法。对于复杂性尿路感染，抗菌药物耐药性的增加限制了许多患者的治疗选择。除了产 ESBL 的大肠埃希菌外，还越来越多地分离出 NDM-1 大肠埃希菌和肺炎克雷伯菌以及其他耐药革兰阴性菌，如不动杆菌属。导管相关性尿路感染（最常见的医院获得性感染）再次引起关注，目前有几个基于证据的感染预防指南。然而，在开发抗黏附性导管材料方面的技术进展仍然令人失望。
