Definitions of Urinary Tract Infection in Current Research: A Systematic Review.

Definitions of Urinary Tract Infection in Current Research: A Systematic Review.
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DOI:
10.1093/ofid/ofad332
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发表时间:
2023-07
影响因子:
4.2
通讯作者:
--
中科院分区:
医学3区
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定义尿路感染(UTI)是复杂的,因为涉及许多临床和诊断参数。在这篇系统性综述中,我们旨在深入了解目前研究中UTI的定义。我们纳入了2019年1月至2022年5月期间发表的47项研究,研究了UTI成人患者的治疗或预防干预措施。85%、28%和55%的研究定义分别要求体征和症状、脓尿和阳性尿培养。5项研究(11%)要求所有3个类别的UTI诊断。显著菌尿的菌落数为103 - 105菌落形成单位/mL。包括急性膀胱炎的12项研究和定义急性肾盂肾炎的12项研究中的2项(17%)均未使用相同的定义。在14项研究中,9项(64%)研究通过宿主因素和全身受累定义了复杂性UTI。总之,在最近的研究中,UTI的定义是异质的,强调了对UTI的共识为基础的研究参考标准的需要。目前研究中使用的尿路感染定义在临床体征和诊断试验方面具有高度异质性。很少有研究符合现有研究指南中提到的症状、脓尿和尿培养标准。
Defining urinary tract infection (UTI) is complex, as numerous clinical and diagnostic parameters are involved. In this systematic review, we aimed to gain insight into how UTI is defined across current studies. We included 47 studies, published between January 2019 and May 2022, investigating therapeutic or prophylactic interventions in adult patients with UTI. Signs and symptoms, pyuria, and a positive urine culture were required in 85%, 28%, and 55% of study definitions, respectively. Five studies (11%) required all 3 categories for the diagnosis of UTI. Thresholds for significant bacteriuria varied from 103 to 105 colony-forming units/mL. None of the 12 studies including acute cystitis and 2 of 12 (17%) defining acute pyelonephritis used identical definitions. Complicated UTI was defined by both host factors and systemic involvement in 9 of 14 (64%) studies. In conclusion, UTI definitions are heterogeneous across recent studies, highlighting the need for a consensus-based, research reference standard for UTI. Urinary tract infection definitions used in current research studies are highly heterogeneous in terms of clinical signs and diagnostic tests. Few studies meet symptom, pyuria, and urine culture criteria mentioned in existing research guidelines.
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