Urologic Clinic, Justus-Liebig-University Giessen, Germany.
Int J Antimicrob Agents. 2011 Dec;38 Suppl:51-7. doi: 10.1016/j.ijantimicag.2011.09.007. Epub 2011 Oct 10.
Urosepsis accounts for approximately 25% of all sepsis cases and may develop from a community-or nosocomial-acquired urinary tract infection (UTI). The underlying UTI is almost exclusively a complicated one with involvement of parenchymatous urogenital organs (e.g. kidneys, prostate). In urosepsis, as in other types of sepsis, the severity of sepsis depends mostly upon the host response. The urological management of urosepsis comprises early diagnosis, early fluid and oxygen treatment, early antibiotic therapy and early control of the complicating factor in the urinary tract. Time from admission to therapy is critical. The shorter the time to effective treatment, the higher is the success rate. This aspect has to become incorporated into the organisational process, including urologists, radiologists and intensive care specialists amongst others. Adequate initial antibiotic therapy has to be insured. This goal implies, however, a wide array of measures over time to ensure a rational antibiotic policy, including microbiologists and clinical pharmacologists. Dosage of an antibiotic in the septic patient generally has to be high to ensure adequate pharmacological exposure in the individual patient.
尿脓毒症约占所有脓毒症病例的 25%，可能由社区获得性或医院获得性尿路感染（UTI）发展而来。潜在的尿路感染几乎都是涉及实质泌尿生殖器官（如肾脏、前列腺）的复杂性尿路感染。与其他类型的脓毒症一样，尿脓毒症的严重程度主要取决于宿主的反应。尿脓毒症的泌尿系统处理包括早期诊断、早期液体和氧气治疗、早期抗生素治疗以及早期控制尿路感染的并发症。从入院到治疗的时间至关重要。治疗开始得越早，成功率越高。这一方面必须纳入组织流程，包括泌尿科医生、放射科医生和重症监护专家等。必须确保初始抗生素治疗足够。然而，这一目标意味着随着时间的推移需要采取一系列措施，以确保合理的抗生素政策，包括微生物学家和临床药理学家。在脓毒症患者中，抗生素的剂量通常需要较高，以确保在个体患者中获得足够的药物暴露。
