Advani Sonali D, Thaden Joshua T, Perez Reinaldo, Stair Sabrina L, Lee Una J, Siddiqui Nazema Y
Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Section of Urology and Renal Transplantation, Virginia Mason Franciscan Health, Seattle, Washington, USA.
Clin Infect Dis. 2025 Mar 17;80(3):e31-e42. doi: 10.1093/cid/ciae653.
Over 50% of adult women experience at least 1 urinary tract infection (UTI) in their lifetime, and almost one-quarter of them will experience a recurrent UTI (rUTI). Recurrent UTI is defined as ≥2 UTIs in a 6-month period or ≥3 UTIs in 12 months (at least 1 of these episodes should be culture-proven to confirm infectious etiology). In this narrative review, we discuss the epidemiology, pathogenesis, diagnosis, and treatment considerations for recurrent uncomplicated cystitis in the adult female population. We provide a focused overview of the comprehensive management of these patients, with input from infectious disease physicians, urogynecologists, and urologists with expertise in rUTI, highlighting updated recommendations by the Infectious Diseases Society of America, American Urologic Association, Canadian Urologic Association, and American Urogynecologic Society. Finally, given the variety of prevention strategies, different treatment goals, and the need for "preference sensitive" decisions, we highlight the need for shared decision-making with patients.
超过50%的成年女性一生中至少经历过1次尿路感染(UTI),其中近四分之一会经历复发性尿路感染(rUTI)。复发性尿路感染的定义为6个月内发生≥2次UTI或12个月内发生≥3次UTI(这些发作中至少有1次应经培养证实以确认感染病因)。在这篇叙述性综述中,我们讨论了成年女性复发性单纯性膀胱炎的流行病学、发病机制、诊断和治疗注意事项。我们提供了这些患者综合管理的重点概述,参考了传染病医生、泌尿妇科医生和在rUTI方面有专业知识的泌尿科医生的意见,突出了美国传染病学会、美国泌尿外科学会、加拿大泌尿外科学会和美国泌尿妇科协会的最新建议。最后,鉴于预防策略的多样性、不同的治疗目标以及做出“偏好敏感”决策的必要性,我们强调了与患者共同决策的必要性。