McKibben Maxim J, Seed Patrick, Ross Sherry S, Borawski Kristy M
Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Infectious Disease, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Urol Clin North Am. 2015 Nov;42(4):527-36. doi: 10.1016/j.ucl.2015.05.006. Epub 2015 Jul 7.
Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment.
对于神经源性膀胱患者而言，尿路感染（UTIs）频发、易复发且伴随终身，在诊断和治疗方面存在挑战。患者常常没有尿路感染的典型症状，而是表现为腹痛或背痛、痉挛加剧以及尿失禁。未能识别和治疗感染会迅速导致危及生命的自主神经反射异常或败血症，而过度治疗则会导致抗生素耐药性，从而限制未来的治疗选择。虽然采用了多种预防方法，但基于证据的做法却很少。有症状的尿路感染的预防和治疗需要一种多模式方法，该方法侧重于膀胱管理以及准确诊断和适当的抗生素治疗。
