Department of Urology, Center for Academic Medicine, Urology-5656, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA, 94304, USA.
Department of Internal Medicine, Aga Khan University Hospital, National Stadium Rd, Karachi, Karachi City, Pakistan.
Curr Urol Rep. 2023 Nov;24(11):533-540. doi: 10.1007/s11934-023-01183-4. Epub 2023 Oct 19.
Asymptomatic bacteriuria (ASB) can be found in the general population but it is more common in catheterized patients. Some patients develop urinary tract infections (UTI) and others stay asymptomatic throughout time. The scientific community lacks a pathophysiologic explanation of why asymptomatic bacteriuria stays asymptomatic most of the time, and why and how it sometimes transitions to UTI. In an attempt to bridge this gap in knowledge, a summary of the current literature is conducted on the pathophysiologic differences between ASB and UTI, beyond their clinical differences.
ASB and UTI cannot be differentiated just by their phylogroup or number of virulence factors. The difference may be in their metabolism gene expression. The literature lacks a pathophysiological explanation of the transition from ASB to UTI, and recent discoveries suggest that metabolic gene expression may hold the key.
无症状性菌尿（ASB）可见于普通人群中，但在留置导尿管的患者中更为常见。一些患者发生尿路感染（UTI），而另一些患者则一直无症状。科学界尚无法解释为什么无症状性菌尿大多数时候仍保持无症状，以及为什么和如何有时会转变为 UTI。为了弥补这一知识空白，对 ASB 和 UTI 之间除临床差异以外的病理生理学差异的现有文献进行了总结。
不能仅根据其菌群或毒力因子数量来区分 ASB 和 UTI。差异可能在于其代谢基因表达。文献中缺乏从 ASB 向 UTI 转变的病理生理学解释，最近的发现表明，代谢基因表达可能是关键。
