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复杂尿路感染未满足的需求:挑战、建议及新出现的治疗途径

Unmet Needs in Complicated Urinary Tract Infections: Challenges, Recommendations, and Emerging Treatment Pathways.

作者信息

Marantidis Joanna, Sussman Rachael D

机构信息

Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA.

出版信息

Infect Drug Resist. 2023 Mar 11;16:1391-1405. doi: 10.2147/IDR.S382617. eCollection 2023.

Abstract

While urinary tract infections (UTIs) are one of the most common types of infections globally, the wide variety of presentations and of severity of disease can make it difficult to manage. The definition for uncomplicated UTIs (uUTIs) is generally regarded as UTIs in healthy, non-pregnant women whereas all other UTIs are considered complicated. There is, however, a lack of consensus definition of complicated UTIs (cUTIs), leading to global differences in management. In addition, the patients who develop complicated UTIs generally have other comorbidities that warrant more urgent intervention. One of the biggest challenges in treating cUTIs is the rise of antimicrobial resistance (AMR). While there have been recent drug approvals for new antibiotic to treat these resistant organisms, a multidisciplinary approach, including regulatory frameworks, provider education and public awareness campaigns, is crucial to limiting unnecessary treatments for asymptomatic bacteriuria (ASB) and uUTIs that can ultimately lead to more severe infections.

摘要

虽然尿路感染(UTIs)是全球最常见的感染类型之一,但临床表现和疾病严重程度的多样性可能使其难以管理。单纯性尿路感染(uUTIs)的定义通常被认为是健康非孕妇的尿路感染,而所有其他尿路感染则被视为复杂性尿路感染。然而,对于复杂性尿路感染(cUTIs)缺乏共识定义,导致全球管理上的差异。此外,发生复杂性尿路感染的患者通常有其他合并症,需要更紧急的干预。治疗复杂性尿路感染的最大挑战之一是抗菌药物耐药性(AMR)的增加。虽然最近有新的抗生素获批用于治疗这些耐药菌,但包括监管框架、医疗服务提供者教育和公众宣传活动在内的多学科方法对于限制无症状菌尿(ASB)和单纯性尿路感染的不必要治疗至关重要,因为这些不必要的治疗最终可能导致更严重的感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d20b/10015946/24aebea1dd01/IDR-16-1391-g0001.jpg

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