Prevention of urinary tract infection in patients with spinal cord injury.
Prevention of urinary tract infection in patients with spinal cord injury.
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脊髓损伤患者尿路感染的预防。
DOI：
10.1080/10790268.2002.11753628
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Darouiche,RabihO
中科院分区：
文献类型：
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作者：
Trautner,BarbaraW;Darouiche,RabihO
背景：尿路感染是脊髓损伤（SCI）患者发病和死亡的主要原因。排尿动力学的改变、尿引管的使用以及频繁接触抗生素使脊髓损伤患者易发生尿路感染复发，通常伴有耐药菌。目的：评价各种预防脊髓损伤人群尿路感染的方法的效果。这些方法包括膀胱管理的类型、导管材料的选择、防腐剂、口服抗生素和实验方法。方法:文献综述。结果：选择一种膀胱管理方法，最大限度地减少异物的使用，同时有效地排出膀胱，是减少尿路感染风险的最佳方法。涂有抗菌剂的导管、局部或囊内抗菌剂以及预防性口服抗生素的主要缺点是，随着时间的推移，细菌会产生耐药性并克服入侵膀胱的障碍。因此，抗感染导管材料、抗生素和防腐剂对长期预防脊髓损伤患者尿路感染是不利的。避免使用抗菌药物的新方法为复发性尿路感染患者带来了希望，但这些技术仍处于实验阶段。结论：膀胱管理方法仍然是降低脊髓损伤患者尿路感染风险的最重要因素。抑制尿路病原体粘附和生物膜形成的实验方法是有前途的。
Background:Urinary tract infection (UTI) is a major cause of morbidity and mortality in individuals with spinal cord injury (SCI). Altered voiding dynamics, use of urinary drainage catheters, and frequent exposure to antibiotic agents predispose individuals with SCI to recurrent episodes of UTI, often with resistant organisms.Objective:To evaluate the efficacy of various methods of UTI prevention in the SCI population. These methods include type of bladder management, choice of catheter materials, antiseptic agents, oral antibiotics, and experimental approaches.Methods:Literature review.Findings:Choosing a method of bladder management that minimizes the use of a foreign body, yet drains the bladder effectively, is the best available means to reduce the risk of UTI. The chief drawback to antimicrobial-coated catheters, topical or intravesicular antiseptic agents, and prophylactic oral antibiotics is that, over time, bacteria become resistant and overcome the obstacles to bladder invasion. Therefore, antiinfective catheter materials, antibiotics, and antiseptic agents are not beneficial for long-term prevention of UTI in persons with SCI. Novel approaches that avoid the use of antimicrobial agents offer hope for patients with recurrent UTI, but these techniques are still in the experimental stage.Conclusions:Method of bladder management remains the most influential factor in reducing the risk of UTI in persons with SCI. Experimental approaches that inhibit adhesion and biofilm formation by uropathogens are promising.