Kuzmenko A V, Kuzmenko V V, Gyaurgiev T A
Voronezh State Medical University n.a. N.N. Burdenko, Voronezh, Russia, Department of Urology of FGBOU VO Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia.
Urologiia. 2020 Jun(3):128-132.
Lower urinary tract infections (LUTI) currently retain the status of one of the most urgent problems of urology. According to extensive microbiological studies of UTIAP I and II, "DARMIS" the most common pathogens that are detected in the urine of women with LUTI are gram-negative bacteria of the Enterobacteriales family, in particular E. Coli. Antibacterial therapy demonstrates high effectiveness in the treatment of uncomplicated LUTI. However, the problem of recurrent infection remains unresolved. Taking into account known side effects of continuous antimicrobial prevention, as well as data on the high frequency of relapses after its cancellation, it is necessary to identify alternative LUTI prevention strategies. The use of D-mannose can be one of these strategies. D-mannose use for the prevention of relapses of INMP is indicated in the clinical recommendations of the American (AUA) and European (EUA) urological associations. D-mannose is a monosaccharide that is extracted from a larch rod. It is relatively quickly absorbed and reaches the peripheral organs in about 30 minutes, after which it is excreted in the urine. The structure of d-mannose allows it to bind to mannose-sensitive E. Coli fimbriae and prevent their adhesion to the urinary tract mucosa. Several studies demonstrated high safety profile and effectiveness of long-term D-mannose treatment in preventing LUTI. The data presented in the literature allow us to recommend patients with recurrent LUTI long term D-mannose intake helps to reduce the severity of symptoms in acute episodes and prolong relapse-free period. As a source of D-mannose, we can recommend Ecocystin 1 sachet 1 time a day.
下尿路感染（LUTI）目前仍是泌尿外科最亟待解决的问题之一。根据UTIAP I和II以及“DARMIS”的广泛微生物学研究，在患有下尿路感染的女性尿液中检测到的最常见病原体是肠杆菌科的革兰氏阴性菌，尤其是大肠杆菌。抗菌治疗在单纯性下尿路感染的治疗中显示出高效性。然而，反复感染的问题仍未得到解决。考虑到持续抗菌预防的已知副作用，以及取消预防后复发频率较高的数据，有必要确定替代的下尿路感染预防策略。使用D-甘露糖可能是这些策略之一。美国泌尿外科学会（AUA）和欧洲泌尿外科学会（EUA）的临床建议指出，使用D-甘露糖可预防下尿路感染复发。D-甘露糖是一种从落叶松杆中提取的单糖。它吸收相对较快，约30分钟后到达外周器官，然后随尿液排出。D-甘露糖的结构使其能够与对甘露糖敏感的大肠杆菌菌毛结合，防止它们粘附于尿路黏膜。多项研究表明，长期使用D-甘露糖治疗预防下尿路感染具有高度安全性和有效性。文献中的数据使我们能够建议复发性下尿路感染患者长期摄入D-甘露糖有助于减轻急性发作时的症状严重程度并延长无复发期。作为D-甘露糖的来源，我们推荐每天服用1包Ecocystin 1。
