老年人的尿路感染和无症状菌尿症。
Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults.
机构信息
Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.
Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard (152), Houston, TX 77030, USA.
出版信息
Infect Dis Clin North Am. 2017 Dec;31(4):673-688. doi: 10.1016/j.idc.2017.07.002.
Abstract
Urinary tract infections (UTIs) are a significant cause of morbidity among older adults. However, antibiotic prescriptions for clinically suspected UTIs are often inappropriate. Health care providers frequently struggle to differentiate UTI from asymptomatic bacteriuria, particularly in patients presenting with nonspecific symptoms. Patients with baseline cognitive impairments that limit history-taking can be particularly challenging. This article reviews the epidemiology and pathogenesis of UTI in older adults. It discusses an approach to diagnosis and treatment focused on recognizing patients who would likely benefit from antibiotic treatment and on identifying patients for whom empiric antibiotic therapy should not be given.
摘要
尿路感染（UTI）是老年人发病率较高的主要原因之一。然而，针对临床疑似 UTI 的抗生素处方往往并不合适。医疗保健提供者常常难以将 UTI 与无症状菌尿区分开来，尤其是在出现非特异性症状的患者中。基线认知功能受损的患者可能难以接受病史采集，因此会带来更多挑战。本文综述了老年人 UTI 的流行病学和发病机制。它讨论了一种诊断和治疗方法，重点是识别可能受益于抗生素治疗的患者，并确定不应给予经验性抗生素治疗的患者。
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