Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina.
Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina; Instituto de Fisiopatología y Bioquímica Clínica - INFIBIOC, Universidad de Buenos Aires, Argentina.
Anaerobe. 2022 Dec;78:102636. doi: 10.1016/j.anaerobe.2022.102636. Epub 2022 Sep 19.
Urinary tract infections (UTIs) caused by anaerobic bacteria have scarcely been reported. Since anaerobic bacteria are commensals of the genitourinary tract, their presence in a urine sample adds ambiguity in making a definitive diagnosis of anaerobic UTI. It is well known that standard urine culture is the gold standard method for the detection, identification, and antimicrobial susceptibility testing of uropathogens. Nonetheless, both the difficulties in establishing them as pathogens and the scarcity of reported anaerobic UTI cases led to the discontinuation of routine urine culture under an anaerobic atmosphere (UCAA). On the other hand, it is important to emphasize that culture-independent methods, such as proteomics and molecular technics, may detect anaerobes directly on a urine sample. Anaerobes are not included in guidelines for the diagnosis and management of UTIs. At the same time, as fastidious uropathogens and antibiotic resistance become more common, accurate pathogen identification becomes even more important for effective UTI treatment. As a result, we conducted a review of the clinical context, pathogen antimicrobial susceptibility, and treatment of patients with anaerobic UTIs. Because UCAA is a contentious topic, we narrowed our search to cases with both negative standard urine culture and positive UCAA.
尿路感染（UTI）由厌氧菌引起的情况很少见。由于厌氧菌是泌尿生殖道的共生菌，因此在尿液样本中存在厌氧菌会使厌氧性 UTI 的明确诊断产生歧义。众所周知，标准尿液培养是检测、鉴定和药敏试验的金标准。尽管如此，由于难以将其确定为病原体以及报告的厌氧性 UTI 病例稀少，因此停止了在厌氧环境下进行常规尿液培养（UCAA）。另一方面，重要的是要强调，非培养方法，如蛋白质组学和分子技术，可以直接在尿液样本上检测厌氧菌。厌氧菌不包含在 UTI 的诊断和管理指南中。同时，由于苛养性尿路病原体和抗生素耐药性变得越来越普遍，准确的病原体鉴定对于有效的 UTI 治疗变得更加重要。因此，我们对厌氧性 UTI 患者的临床背景、病原体药敏性和治疗进行了综述。由于 UCAA 是一个有争议的话题，我们将搜索范围缩小到标准尿液培养阴性且 UCAA 阳性的病例。
