无症状患者尿液培养阳性的处理方法。
Approach to a positive urine culture in a patient without urinary symptoms.
机构信息
Department of Medicine, Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA; Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby, Houston, TX 77098, USA.
出版信息
Infect Dis Clin North Am. 2014 Mar;28(1):15-31. doi: 10.1016/j.idc.2013.09.005. Epub 2013 Dec 8.
Abstract
Asymptomatic bacteriuria (ASB) is a condition in which bacteria are present in a noncontaminated urine sample collected from a patient without signs or symptoms related to the urinary tract. ASB must be distinguished from symptomatic urinary tract infection (UTI) by the absence of signs and symptoms compatible with UTI or by clinical determination that a nonurinary cause accounts for the patient's symptoms. The overall purpose of this review is to promote an awareness of ASB as a distinct condition from UTI and to empower clinicians to withhold antibiotics in situations in which antimicrobial treatment of bacteriuria is not indicated.
摘要
无症状性菌尿症（ASB）是指从无尿路相关症状或体征的患者采集的非污染尿液样本中存在细菌的一种状况。ASB 必须与有症状的尿路感染（UTI）相区别，其依据是缺乏与 UTI 相符的症状或体征，或临床判断表明患者的症状由非尿路原因引起。本次综述的总体目的是提高对 ASB 与 UTI 不同的认识，并使临床医生在抗菌治疗菌尿症无指征的情况下能够避免使用抗生素。
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2
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BMJ. 2013 Jun 11;346:f3147. doi: 10.1136/bmj.f3147.
3
Reduction of urinary catheter use and prescription of antibiotics for asymptomatic bacteriuria in hospitalised patients in internal medicine: before-and-after intervention study.减少内科住院患者中无症状菌尿症的导尿管使用和抗生素处方：前后干预研究。
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4
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