Pigrau Carlos
Servicio de Enfermedades Infecciosas, Hospital Vall d'Hebron, Universitat Autònoma, Barcelona, España.
Enferm Infecc Microbiol Clin. 2013 Nov;31(9):614-24. doi: 10.1016/j.eimc.2012.11.015. Epub 2013 Jan 31.
Nosocomial urinary tract infections (UTI) are mainly related to urinary catheterisation. In this paper we review the pathogenic mechanisms, particularly the route by which the microorganisms colonise the urinary tract, their adhesion ability, and their capacity to form biofilms, and are related not only to the microorganism but also to the type of urinary catheter. The aetiology of catheter related UTI is variable, and multiresistant microorganisms are often isolated, making empirical antibiotic therapy complex. Clinical findings are frequently atypical, and its diagnosis is difficult. The therapeutic management of catheter-related UTI should be stratified according to the type of UTI: asymptomatic bacteriuria should not be habitually treated, but patients with septic shock should receive a broad spectrum antibiotic. In this review, the value of the different preventive measures are discussed.
医院获得性尿路感染（UTI）主要与导尿有关。在本文中，我们综述了致病机制，特别是微生物在尿路定植的途径、它们的黏附能力以及形成生物膜的能力，这些不仅与微生物有关，还与导尿管的类型有关。导尿管相关UTI的病因多种多样，常分离出多重耐药微生物，使得经验性抗生素治疗变得复杂。临床症状常常不典型，诊断困难。导尿管相关UTI的治疗管理应根据UTI的类型进行分层：无症状菌尿通常不应常规治疗，但感染性休克患者应接受广谱抗生素治疗。在本综述中，讨论了不同预防措施的价值。
