Cipriani Chiara, Carilli Marco, Rizzo Marta, Miele Martino Tony, Sinibaldi-Vallebona Paola, Matteucci Claudia, Bove Pierluigi, Balestrieri Emanuela
Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
Robotic and Minimally Invasive Urology Unit, Azienda Ospedaliera Universitaria, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Antibiotics (Basel). 2025 Feb 1;14(2):144. doi: 10.3390/antibiotics14020144.
Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. They occur in the urinary system when a microorganism, commonly present on the perineal skin or rectum, reaches the bladder through the urethra, and adheres to the luminal surface of uroepithelial cells, forming biofilms. The treatment of UTIs includes antibiotics, but their indiscriminate use has favored the development of multidrug-resistant bacteria strains, which represent a serious challenge to today's microbiology. The pathogenesis of the infection and antibiotic resistance synergistically contribute to hindering the eradication of the disease while favoring the establishment of persistent infections. The repeated requirement for antibiotic treatment and the limited therapeutic options have further contributed to the increase in antibiotic resistance and the occurrence of potential relapses by therapeutic failure. To limit antimicrobial resistance and broaden the choice of non-antibiotic preventive approaches, this review reports studies focused on the bacteriostatic/bactericidal activity, inhibition of bacterial adhesion and quorum sensing, restoration of uroepithelial integrity and immune response of molecules, vitamins, and compounds obtained from plants. To date, different supplementations are recommended by the European Association of Urology for the management of UTIs as an alternative approach to antibiotic treatment, while a variety of bioactive compounds are under investigation, mostly at the level of in vitro and preclinical studies. Although the evidence is promising, they are far from being included in the clinical practice of UTIs.
尿路感染（UTIs）是全球最常见的细菌感染之一。当通常存在于会阴皮肤或直肠的微生物通过尿道进入膀胱，并粘附在尿路上皮细胞的腔表面形成生物膜时，泌尿系统就会发生感染。UTIs的治疗包括使用抗生素，但抗生素的滥用助长了多重耐药菌株的产生，这对当今的微生物学构成了严峻挑战。感染的发病机制和抗生素耐药性协同作用，阻碍了疾病的根除，同时助长了持续性感染的形成。对抗生素治疗的反复需求和有限的治疗选择进一步导致了抗生素耐药性的增加以及治疗失败导致潜在复发的发生。为了限制抗菌药物耐药性并拓宽非抗生素预防方法的选择范围，本综述报告了一些研究，这些研究聚焦于从植物中获得的分子、维生素和化合物的抑菌/杀菌活性、对细菌粘附和群体感应的抑制作用、尿路上皮完整性的恢复以及免疫反应。迄今为止，欧洲泌尿外科学会推荐了不同的补充剂用于UTIs的管理，作为抗生素治疗的替代方法，同时多种生物活性化合物正在研究中，大多处于体外和临床前研究阶段。尽管证据很有前景，但它们远未被纳入UTIs的临床实践中。
