老年人下尿路感染的诊断与治疗。
Diagnosis and management of urinary tract infection in older adults.
机构信息
Yale University School of Medicine, 300 Cedar Street, New Haven, CT 06520-8002, USA.
Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, CT 06520-8022, USA.
出版信息
Infect Dis Clin North Am. 2014 Mar;28(1):75-89. doi: 10.1016/j.idc.2013.10.004. Epub 2013 Dec 8.
Abstract
Urinary tract infection (UTI) is a commonly diagnosed infection in older adults. Despite consensus guidelines developed to assist providers in diagnosing UTI, distinguishing symptomatic UTI from asymptomatic bacteriuria (ASB) in older adults is problematic, as many older adults do not present with localized genitourinary symptoms. This article summarizes the recent literature and guidelines on the diagnosis and management of UTI and ASB in older adults.
摘要
尿路感染（UTI）是老年人中常见的诊断性感染。尽管已经制定了共识指南来帮助医生诊断 UTI，但在老年人中区分有症状的 UTI 和无症状菌尿（ASB）仍然存在问题，因为许多老年人没有出现局部泌尿生殖系统症状。本文总结了关于老年人 UTI 和 ASB 的诊断和管理的最新文献和指南。
相似文献
1
Diagnosis and management of urinary tract infection in older adults.
Infect Dis Clin North Am. 2014 Mar;28(1):75-89. doi: 10.1016/j.idc.2013.10.004. Epub 2013 Dec 8.
2
Bacteruria and Urinary Tract Infections in the Elderly.
Urol Clin North Am. 2015 Nov;42(4):561-8. doi: 10.1016/j.ucl.2015.07.002. Epub 2015 Aug 19.
3
Similar Neutrophil-Driven Inflammatory and Antibacterial Responses in Elderly Patients with Symptomatic and Asymptomatic Bacteriuria.
Infect Immun. 2015 Oct;83(10):4142-53. doi: 10.1128/IAI.00745-15. Epub 2015 Aug 3.
4
Asymptomatic bacteriuria is an independent predictor of urinary tract infections in an ambulatory cirrhotic population: a prospective evaluation.
Liver Int. 2014 Jul;34(6):e39-44. doi: 10.1111/liv.12435. Epub 2014 Jan 7.
5
Management of Bacteriuria and Urinary Tract Infections in the Older Adult.
Urol Clin North Am. 2024 Nov;51(4):585-594. doi: 10.1016/j.ucl.2024.07.002. Epub 2024 Aug 7.
6
Approach to a positive urine culture in a patient without urinary symptoms.
Infect Dis Clin North Am. 2014 Mar;28(1):15-31. doi: 10.1016/j.idc.2013.09.005. Epub 2013 Dec 8.
7
Asymptomatic bacteriuria and urinary tract infection in pregnant women with and without diabetes: Cohort study.
Eur J Obstet Gynecol Reprod Biol. 2018 Mar;222:176-181. doi: 10.1016/j.ejogrb.2017.12.013. Epub 2017 Dec 7.
8
Urinary tract infections in older women: a clinical review.
JAMA. 2014 Feb 26;311(8):844-54. doi: 10.1001/jama.2014.303.
9
Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults.
Infect Dis Clin North Am. 2017 Dec;31(4):673-688. doi: 10.1016/j.idc.2017.07.002.
10
Advances in the Treatment of Urinary Tract Infection and Bacteriuria in Pregnancy.
Urol Clin North Am. 2024 Nov;51(4):571-583. doi: 10.1016/j.ucl.2024.07.001. Epub 2024 Aug 17.
引用本文的文献
1
Prevalence, Diagnostic Accuracy, and Antimicrobial Resistance Patterns of Uropathogens in Urinary Tract Infections at a Health Facility in Kumasi, Ghana.
Microbiologyopen. 2025 Oct;14(5):e70028. doi: 10.1002/mbo3.70028.
2
The urinary microbiome distinguishes symptomatic urinary tract infection from asymptomatic older adult patients presenting to the emergency department.
Virulence. 2025 Dec;16(1):2546063. doi: 10.1080/21505594.2025.2546063. Epub 2025 Aug 13.
3
Validation of urinary biomarkers for accurate diagnosis of urinary tract infections in older adults across primary care, hospitals and long-term care facilities in the Netherlands and UK (UTI-GOLD): a multicentre observational study protocol.
BMJ Open. 2025 Jun 18;15(6):e103311. doi: 10.1136/bmjopen-2025-103311.
4
Water intake, hydration, and weight management: the glass is half-full!
Physiol Behav. 2025 Aug 1;297:114953. doi: 10.1016/j.physbeh.2025.114953. Epub 2025 May 13.
5
Analysis of the Distribution Characteristics and Changes of Drug Resistance of Pathogens in Patients with Urinary Tract Infection Across Southwest China From 2019 to 2023.
Infect Drug Resist. 2025 Mar 17;18:1491-1502. doi: 10.2147/IDR.S512409. eCollection 2025.
6
Association of Posttransplant Circulating 25-Hydroxyvitamin D and Late-Onset Infections Among Kidney Transplant Recipients: The Wisconsin Allograft Recipient Database (WisARD).
Transpl Infect Dis. 2025 Mar-Apr;27(2):e70016. doi: 10.1111/tid.70016. Epub 2025 Mar 3.
7
A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study.
Scand J Prim Health Care. 2025 Jun;43(2):500-509. doi: 10.1080/02813432.2025.2463455. Epub 2025 Feb 11.
8
Epidemiological trends and predictions of urinary tract infections in the global burden of disease study 2021.
Sci Rep. 2025 Feb 8;15(1):4702. doi: 10.1038/s41598-025-89240-5.
9
Antibiotic Overprescription for "Urinary Tract Infections" Is Associated With Poor Diagnostic Stewardship and Low Adherence to Guidelines.
Neurourol Urodyn. 2025 Feb;44(2):382-389. doi: 10.1002/nau.25598. Epub 2024 Dec 4.
10
Risk factors for septic shock in older patients with urinary tract infection.
Clin Exp Nephrol. 2025 Mar;29(3):368-375. doi: 10.1007/s10157-024-02563-x. Epub 2024 Nov 25.
本文引用的文献
1
Women with symptoms of uncomplicated urinary tract infection are often willing to delay antibiotic treatment: a prospective cohort study.
BMC Fam Pract. 2013 May 31;14:71. doi: 10.1186/1471-2296-14-71.
2
Lack of positive association between falls and bacteriuria plus pyuria in older nursing home residents.
J Am Geriatr Soc. 2013 Apr;61(4):653-4. doi: 10.1111/jgs.12177.
3
Does adherence to the Loeb minimum criteria reduce antibiotic prescribing rates in nursing homes?
J Am Med Dir Assoc. 2013 Apr;14(4):309.e1-7. doi: 10.1016/j.jamda.2013.01.002. Epub 2013 Feb 12.
4
Nitrofurantoin contraindication in patients with a creatinine clearance below 60 mL/min: looking for the evidence.
Ann Pharmacother. 2013 Jan;47(1):106-11. doi: 10.1345/aph.1R352. Epub 2013 Jan 22.
5
Challenges in assessing nursing home residents with advanced dementia for suspected urinary tract infections.
J Am Geriatr Soc. 2013 Jan;61(1):62-6. doi: 10.1111/jgs.12070.
6
Urinary tract infection in male veterans: treatment patterns and outcomes.
JAMA Intern Med. 2013 Jan 14;173(1):62-8. doi: 10.1001/2013.jamainternmed.829.
7
Cranberries for preventing urinary tract infections.
Cochrane Database Syst Rev. 2012 Oct 17;10(10):CD001321. doi: 10.1002/14651858.CD001321.pub5.
8
Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women.
Braz J Infect Dis. 2012 Sep-Oct;16(5):436-41. doi: 10.1016/j.bjid.2012.06.025. Epub 2012 Sep 10.
9
Surveillance definitions of infections in long-term care facilities: revisiting the McGeer criteria.
Infect Control Hosp Epidemiol. 2012 Oct;33(10):965-77. doi: 10.1086/667743.
10
Incidence of antibiotic-resistant Escherichia coli bacteriuria according to age and location of onset: a population-based study from Olmsted County, Minnesota.
Mayo Clin Proc. 2012 Aug;87(8):753-9. doi: 10.1016/j.mayocp.2012.02.025. Epub 2012 Jul 13.
Zotero 插件