大肠杆菌和奇异变形杆菌引起的混合性导管相关的尿路感染（2008年1月美国CMR）

David

Clinical Microbiology Reviews, January 2008, p. 26-59, Vol. 21, No. 1


Complicated Catheter-Associated Urinary Tract Infections Due to Escherichia coli and Proteus mirabilis
大肠杆菌和奇异变形杆菌引起的混合性导管相关的尿路感染
S. M. Jacobsen,1 D. J. Stickler,2 H. L. T. Mobley,3 and M. E. Shirtliff1,4*
Department of Microbiology and Immunology, School of Medicine, University of Maryland—Baltimore, 655 W. Baltimore Street, Baltimore, Maryland 21201,1 Cardiff School of Biosciences, Cardiff University, Cardiff, Wales CF10 3TL, United Kingdom,2 Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan 48109,3 Department of Biomedical Sciences, Dental School, University of Maryland—Baltimore, 650 W. Baltimore Street, Baltimore, Maryland 212014

Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. These infections are often caused by Escherichia coli and Proteus mirabilis. Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.

麦苗

David越来越棒了，都有全文，谢谢分享．

楚楚

单是英文参考文献就有474篇:L

David

Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. （导管相关的尿路感染是最常见的医院感染类型，由于并发症多和经常复发而为临床所关注。）These infections are often caused by Escherichia coli and Proteus mirabilis. （这些感染经常有大肠杆菌和奇异变形杆菌引起。）Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. （引起尿路感染的革兰阴性杆菌表达大量致病因子，导致对宿主的损伤，包括黏附、移动、生物膜形成、免疫逃避和营养获得等。）These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. （通过限制导管的使用和确保医护人员正确使用Foley闭合导管，能够减少这些感染。）A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. （大量的研究如安全套和耻骨上导管，间歇性导尿术，新的导管表面，包被抗生素的导管，使用益生菌，但不是很成功。）While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. （而诊断有症状和无症状的尿路感染却是一个有争议的问题，通常一致认为一旦病人出现尿路感染症状时，导管应该尽可能去除。）Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.（集中在尿路感染致病机理的研究将会对疾病的发生有更好的理解，也会对新的诊断，预防和治疗有所发展。）

缭绕

据我这些年的监测，尿路混合性的无症状性菌尿感染还是有的，但困惑的是95%的病人没有全身感染的症状，不用药治疗、导尿管不是想拔就能拔的，脑外科的病人拔得了吗？
有时真的很疑惑，这样的尿感似乎对其他病人更有影响，比如质粒介导的ESBL科内爆发？:o

树叶儿

David 发表于 2008-2-20 12:06

                               
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Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial i ...

版主老师：1月前我院收了一例病人，因为肛瘘感染，从上级医院转回来治疗，时间约2.5年，专科医生因为病人脓性分泌物多，给他进行了扩创，现有臀部窦道，脓性分泌物培养是奇异变形杆菌，对头孢塞肟、喹洛酮敏感、伤口久治不愈，目前换药见：脓性分泌物变成了豆渣样分泌物，老师有什么建议让伤口加快愈合？