Kranz Jennifer, Stangl Fabian, Kuppe Christoph, Wagenlehner Florian, Saar Matthias, Schneidewind Laila
Klinik für Urologie und Kinderurologie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.
Urologie. 2022 Jun;61(6):596-601. doi: 10.1007/s00120-022-01832-5. Epub 2022 May 6.
Urinary tract infections (UTIs) are characterized by a broad clinical presentation ranging from uncomplicated cystitis to septic shock. 9-31% of all septicemias have a urogenital focus and are referred to as urosepsis. Urosepsis often occurs in the context of health system-associated infections. Obstructive uropathy (e.g., urolithiasis, tumors, strictures) is a major risk factor. The severity and course of urosepsis depend not only on the pathogenicity of the pathogen but also on the type and extent of the individual immune response. Therapy is divided into causal (antimicrobial therapy and focal sanitation), supportive (hemodynamic and pulmonal stabilization), and adjunctive (glucocorticoid and insulin therapy) therapy and should be initiated without delay. Due to demographic change, a further increase in urosepsis is expected in the future, so every urologist should be familiar with targeted diagnostics and effective therapy.
尿路感染(UTIs)的临床表现广泛,从不复杂的膀胱炎到感染性休克。所有败血症中有9% - 31%有泌尿生殖系统病灶,被称为尿脓毒症。尿脓毒症常发生在与卫生系统相关的感染背景下。梗阻性尿路病(如尿路结石、肿瘤、狭窄)是一个主要危险因素。尿脓毒症的严重程度和病程不仅取决于病原体的致病性,还取决于个体免疫反应的类型和程度。治疗分为病因治疗(抗菌治疗和局部清洁)、支持治疗(血流动力学和肺部稳定)和辅助治疗(糖皮质激素和胰岛素治疗),应立即开始。由于人口结构变化,预计未来尿脓毒症会进一步增加,因此每位泌尿外科医生都应熟悉针对性诊断和有效治疗。