Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada.
Curr Opin Infect Dis. 2014 Feb;27(1):90-6. doi: 10.1097/QCO.0000000000000019.
Asymptomatic bacteriuria is a common finding. Inappropriate antimicrobial treatment of asymptomatic bacteriuria has been identified as a major issue for antimicrobial stewardship programs. This review summarizes and evaluates recent studies which extend our knowledge of the occurrence, management, and outcomes of bacteriuria.
The reported prevalence of bacteriuria is higher in some developing countries than generally reported for developed countries, but reasons for this remain unclear. Clinical studies of young women, renal transplant patients, and patients undergoing minor nontraumatic urologic procedures confirm that treatment of asymptomatic bacteriuria for these populations is not beneficial, and may be harmful. There is also no benefit for treatment of asymptomatic bacteriuria prior to orthopedic surgery to decrease postoperative surgical site infection. Studies continue to report substantial inappropriate antimicrobial use for treatment of asymptomatic bacteriuria.
Recent publications confirm that asymptomatic bacteriuria is benign in most patients. Management strategies for pregnant women with recurrent bacteriuria require further clarification. There is a continuing problem with inappropriate treatment of asymptomatic bacteriuria, and sustainable strategies to optimize antimicrobial use for this problem are needed.
无症状菌尿较为常见。不恰当地治疗无症状菌尿已被确定为抗菌药物管理项目的主要问题。本综述总结和评估了最近的研究，这些研究扩展了我们对菌尿发生、管理和结局的认识。
一些发展中国家报告的菌尿患病率高于发达国家的一般报告，但原因尚不清楚。对年轻女性、肾移植患者和接受小型非创伤性泌尿科手术的患者的临床研究证实，对这些人群的无症状菌尿进行治疗并无益处，反而可能有害。在骨科手术前治疗无症状菌尿以减少术后手术部位感染也没有益处。研究继续报告大量不恰当地使用抗菌药物治疗无症状菌尿。
最近的出版物证实，无症状菌尿在大多数患者中是良性的。复发性菌尿孕妇的管理策略需要进一步阐明。不恰当地治疗无症状菌尿仍然是一个问题，需要制定可持续的策略来优化这种情况下抗菌药物的使用。
