Garini G, Mazzi A
Istituto di Clinica Medica e Nefrologia, Università degli Studi Parma.
Ann Ital Med Int. 1995 Jan-Mar;10(1):25-30.
Urinary tract infections (UTI) are the most common of all the bacterial infections affecting humans during their life span. In adult patients, UTI may be categorized into the following groups: acute uncomplicated cystitis, acute uncomplicated pyelonephritis, recurrent bacterial UTI infections, asymptomatic bacteriuria, complicated UTI, acute and chronic bacterial prostatitis. In patients with uncomplicated cystitis, short-course (3 days) empirical therapy is more effective than single dose therapy. Recurrent cystitis can be effectively managed by continuous antimicrobial prophylaxis. Acute pyelonephritis in patients with anatomically normal urinary tracts should be treated with antimicrobial therapy for 10 to 14 days. Complicated infections require a full 10- to 14-day course of antimicrobial therapy. Urologic evaluation in patients with acute pyelonephritis or recurrent infections should not be routinely performed. Screening for asymptomatic bacteriuria is unnecessary in adults, except in particular circumstances. There is little evidence that UTI in adult patients lead to progressive chronic renal injury, unless complicating factors are concurrently present.
尿路感染（UTI）是人类一生中最常见的细菌感染。在成年患者中，UTI可分为以下几类：急性单纯性膀胱炎、急性单纯性肾盂肾炎、复发性细菌性UTI感染、无症状菌尿、复杂性UTI、急性和慢性细菌性前列腺炎。在单纯性膀胱炎患者中，短疗程（3天）经验性治疗比单剂量治疗更有效。复发性膀胱炎可通过持续抗菌预防有效控制。尿路解剖结构正常的患者发生急性肾盂肾炎，应采用抗菌治疗10至14天。复杂性感染需要完整的10至14天抗菌治疗疗程。急性肾盂肾炎或复发性感染患者不应常规进行泌尿外科评估。除特殊情况外，成年人无需筛查无症状菌尿。几乎没有证据表明成年患者的UTI会导致进行性慢性肾损伤，除非同时存在复杂因素。
