aClinic of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Giessen bTechnical University, Munich, Germany.
Curr Opin Infect Dis. 2014 Feb;27(1):97-101. doi: 10.1097/QCO.0000000000000024.
The purpose of this review is to highlight advances in research on urinary tract infections (UTIs) and bacterial prostatitis in men in the preceding year.
The antiseptic properties of the prostate secretions might be an important factor for prevention of recurrency. Risk factors for UTI in men include prostate enlargement and urological interventions, such as transrectal prostate biopsy. Preventive treatment of prostate enlargement has been demonstrated to reduce frequency of UTI. Ensuing infections after prostate biopsy, such as UTI and bacterial prostatitis, are increasing due to increasing rates of fluoroquinolone resistance. The increasing global antibiotic resistance also significantly affects management of UTI in men, and therefore calls for alternative strategies.Apart from prevention of complicating factors leading to UTI, a more thorough understanding of the pathophysiology may play a more important role in the future, to define new targets for treatment. Interesting results that might interfere with the intracellular mucosal bacterial load in the bladder wall have been found in the last years.
UTI in men and bacterial prostatitis are currently underrepresented in the medical literature. Increasing antibacterial resistance calls for novel strategies in the prevention and management of UTI and bacterial prostatitis in men.
本综述的目的在于强调过去一年中有关男性尿路感染(UTI)和细菌性前列腺炎研究的进展。
前列腺分泌物的消毒特性可能是预防复发的一个重要因素。男性 UTI 的危险因素包括前列腺增大和泌尿科干预,如经直肠前列腺活检。已经证明预防性治疗前列腺增大可以降低 UTI 的频率。由于氟喹诺酮类药物耐药率的增加,前列腺活检后的继发感染(如 UTI 和细菌性前列腺炎)正在增加。全球抗生素耐药性的增加也极大地影响了男性 UTI 的管理,因此需要替代策略。除了预防导致 UTI 的复杂因素外,对发病机制的更深入了解可能在未来发挥更重要的作用,以确定治疗的新靶点。过去几年发现了一些有趣的结果,这些结果可能会干扰膀胱壁的细胞内黏膜细菌负荷。
目前,男性 UTI 和细菌性前列腺炎在医学文献中代表性不足。抗菌耐药性的增加要求在男性 UTI 和细菌性前列腺炎的预防和管理方面采用新策略。