Urinary tract infections during pregnancy
Urinary tract infections during pregnancy
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DOI：
10.1345/aph.1d630
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发表时间：
2004-10-01
影响因子：
2.9
通讯作者：
Bustillo, G
中科院分区：
文献类型：
--
作者：
Le, J;Briggs, GG;Bustillo, G
目的：对妊娠期尿路感染(UTIs)进行全面回顾。对尿路感染的流行病学、发病机制、耐药性、临床特征、诊断、治疗和预防等方面进行综述。数据来源：Medline(1966-2003-08)和Cochrane图书馆检索词，检索词为尿路感染、肾盂肾炎、膀胱炎、无症状性菌尿和耐药性。只收录了与怀孕有关的文章。已发表的大多数文献都是综述文章；原始临床研究的数量有限。数据综合：尿路感染是妊娠期最常见的细菌感染。它们的特征是沿尿路的任何地方都存在显著的细菌。肾盂肾炎是最常见的严重细菌感染，可导致围产期和孕产妇并发症，包括早产、低出生体重婴儿、胎儿死亡率、先兆子痫、妊娠高血压综合征、贫血、血小板减少和一过性肾功能不全。肠杆菌科细菌占尿路感染的90%。常用的抗生素有呋喃妥因、头孢唑林、头孢氨苄、头孢曲松和庆大霉素。结论：妊娠期尿路感染的治疗需要正确的诊断性检查和对抗菌药物的透彻了解，以优化母体结局，确保胎儿的安全，并防止导致胎儿和母亲显著发病率和死亡率的并发症。
OBJECTIVE: To provide a comprehensive review of urinary tract infections (UTIs) during pregnancy. All aspects of UTIs, including epidemiology, pathogenesis, resistance, clinical features, diagnosis, treatment, and prevention, were reviewed.DATA SOURCES: MEDLINE (1966-August 2003) and Cochrane Library searches were performed using the key search terms urinary tract infection, pyelonephritis, cystitis, asymptomatic bacteriuria, and resistance.STUDY SELECTION AND DATA EXTRACTION: All article abstracts were evaluated for relevance. Only articles pertaining to pregnancy were included. The majority of published literature were review articles; the number of original clinical studies was limited.DATA SYNTHESIS: UTIs are the most common bacterial infections during pregnancy. They are characterized by the presence of significant bacteria anywhere along the urinary tract. Pyelonephritis is the most common severe bacterial infection that can lead to perinatal and maternal complications including premature delivery, infants with low birth weight, fetal mortality, preeclampsia, pregnancy-induced hypertension, anemia, thrombocytopenia, and transient renal insufficiency. Enterobacteriaceae account for 90% of UTIs. The common antibiotics used are nitrofurantoin, cefazolin, cephalexin, ceftriaxone, and gentamicin.CONCLUSIONS: Therapeutic management of UTIs in pregnancy requires proper diagnostic workup and thorough understanding of antimicrobial agents to optimize maternal outcome, ensure safety to the fetus, and prevent complications that lead to significant morbidity and mortality in both the fetus and the mother.