成人复发性尿路感染和无症状菌尿症
Recurrent Urinary Tract Infections and Asymptomatic Bacteriuria in Adults.
作者信息
Hernández-Hernández David, Padilla-Fernández Bárbara, Ortega-González María Yanira, Castro-Díaz David Manuel
机构信息
Department of Urology, Complejo Hospitalario Universitario de Canarias, La Laguna, Tenerife Spain.
Departamento de Cirugía, Facultad de Medicina, Universidad de La Laguna, Tenerife, Spain.
出版信息
Curr Bladder Dysfunct Rep. 2022;17(1):1-12. doi: 10.1007/s11884-021-00638-z. Epub 2021 Dec 1.
Abstract
PURPOSE OF REVIEW
Our goal was to summarize recent evidence regarding recurrent urinary tract infections and asymptomatic bacteriuria in different adult populations.
RECENT FINDINGS
Several research groups are focused on the description of resident bacterial flora in the bladder and urinary dysbiosis in the microbiome era. Even the definitions might change in light of these discoveries. However, the role of urinary microbiome and bacterial interference has still to be determined.
SUMMARY
Systematic treatment of asymptomatic bacteriuria is not recommended and even classic indications such as asymptomatic bacteriuria in pregnant women are controversial. In fact, its treatment is associated with a higher probability of symptomatic UTI and a higher prevalence of antibiotic-resistant bacteria. Improving the diagnosis of asymptomatic bacteriuria and optimizing the management of recurrent urinary tract infections, especially through non-antibiotics measures, are needed in order to minimise antimicrobial resistance.
摘要
综述目的
我们的目标是总结近期关于不同成年人群复发性尿路感染和无症状菌尿的证据。
近期研究结果
几个研究小组专注于膀胱中常驻细菌菌群的描述以及微生物组时代的尿路生态失调。鉴于这些发现，甚至定义可能都会改变。然而，尿微生物组和细菌干扰的作用仍有待确定。
总结
不建议对无症状菌尿进行系统治疗，甚至孕妇无症状菌尿等经典指征也存在争议。事实上，其治疗与有症状性尿路感染的更高概率以及抗生素耐药菌的更高患病率相关。为了尽量减少抗菌药物耐药性，需要改进无症状菌尿的诊断并优化复发性尿路感染的管理，尤其是通过非抗生素措施。
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