Medina Martha, Castillo-Pino Edgardo
Hospital Nacional Docente Madre-Niño San Bartolome, Lima, Perú.
Department of Obstetrics and Gynecology, School of Medicine, University of the Republic, Hospital de Clínicas, Av Italia, 11600 Montevideo, Uruguay.
Ther Adv Urol. 2019 May 2;11:1756287219832172. doi: 10.1177/1756287219832172. eCollection 2019 Jan-Dec.
Urinary tract infections (UTIs) are the most common outpatient infections, with a lifetime incidence of 50-60% in adult women. This is a narrative review aimed at acting as an introduction to the epidemiology and burden of UTIs. This review is based on relevant literature according to the experience and expertise of the authors. The prevalence of UTI increases with age, and in women aged over 65 is approximately double the rate seen in the female population overall. Etiology in this age group varies by health status with factors such as catheterization affecting the likelihood of infection and the pathogens most likely to be responsible. In younger women, increased sexual activity is a major risk factor for UTIs and recurrence within 6 months is common. In the female population overall, more serious infections such as pyelonephritis are less frequent but are associated with a significant burden of care due to the risk of hospitalization. Healthcare-associated UTIs (HAUTIs) are the most common form of healthcare-acquired infection. Large global surveys indicate that the nature of pathogens varies between the community and hospital setting. In addition, the pathogens responsible for HAUTIs vary according to region making adequate local data key to infection control. UTIs create a significant societal and personal burden, with a substantial number of medical visits in the United States every year being related to UTIs. European data indicate that recurrent infections are related to increased absenteeism and physician visits. In addition, quality of life measures are significantly impacted in women suffering from recurrent UTIs. Data suggest that nonantimicrobial prophylactic strategies offer an opportunity to reduce both the rate of UTIs and the personal burden experience by patients.
尿路感染(UTIs)是最常见的门诊感染,成年女性终生发病率为50%-60%。这是一篇叙述性综述,旨在介绍尿路感染的流行病学和负担情况。本综述依据作者的经验和专业知识,基于相关文献撰写。尿路感染的患病率随年龄增长而增加,65岁以上女性的患病率约为总体女性人群的两倍。该年龄组的病因因健康状况而异,诸如导尿等因素会影响感染可能性以及最可能致病的病原体。在年轻女性中,性活动增加是尿路感染的主要危险因素,6个月内复发很常见。在总体女性人群中,诸如肾盂肾炎等更严重的感染较少见,但因有住院风险,会带来重大护理负担。医疗保健相关尿路感染(HAUTIs)是医疗保健获得性感染最常见的形式。全球大型调查表明,社区和医院环境中病原体的性质有所不同。此外,导致HAUTIs的病原体因地区而异,因此充足的本地数据是感染控制的关键。尿路感染造成了重大的社会和个人负担,美国每年有大量医疗就诊与尿路感染有关。欧洲数据表明,复发性感染与旷工增加和就医次数增多有关。此外,复发性尿路感染女性的生活质量指标受到显著影响。数据表明,非抗菌预防策略为降低尿路感染发生率和患者个人负担提供了契机。