Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs
Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs
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DOI：
10.1067/mda.2003.7
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发表时间：
2003-02-01
影响因子：
4
通讯作者：
Foxman, B
中科院分区：
文献类型：
--
作者：
Foxman, B
尿路感染（UTI）被认为是最常见的细菌感染。根据1997年全国门诊医疗保健调查和全国医院门诊医疗保健调查，UTI占近700万次门诊就诊和100万次急诊就诊，导致10万人住院。然而，很难准确评估尿路感染的发病率，因为它们在美国不是可报告的疾病。这种情况进一步复杂化的事实是，准确的诊断取决于症状的存在和阳性尿培养，虽然在大多数门诊设置，这种诊断是没有文化的好处。女性比男性更容易经历UTI。近三分之一的女性在24岁之前至少有一次UTI发作，需要抗菌治疗。几乎一半的女性在一生中会经历1次UTI。UTI风险增加的特定亚群包括婴儿、孕妇、老年人、脊髓损伤和/或导管患者、糖尿病或多发性硬化症患者、获得性免疫缺陷疾病综合征/人类免疫缺陷病毒患者和基础泌尿系统异常患者。导管相关性UTI是最常见的医院感染，在医院和疗养院中占> 100万例。UTI的风险随着导管插入持续时间的增加而增加。在非住院老年人群中，尿路感染是第二种最常见的感染形式，占所有感染的近25%。在非梗阻性、非妊娠的成年女性中，急性单纯性UTI被认为是一种良性疾病，没有长期的医疗后果。然而，UTI增加了孕妇肾盂肾炎、早产和胎儿死亡的风险，并与儿科患者肾功能受损和终末期肾病相关。从财政上讲，社区获得的UTI的估计年度成本很高，约为16亿美元。
Urinary tract infections (UTIs) are considered to be the most common bacterial infection. According to the 1997 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, UTI accounted for nearly 7 million office visits and 1 million emergency department visits, resulting in 100,000 hospitalizations. Nevertheless, it is difficult to accurately assess the incidence of UTIs, because they are not reportable diseases in the United States. This situation is further complicated by the fact that accurate diagnosis depends on both the presence of symptoms and a positive urine culture, although in most outpatient settings this diagnosis is made without the benefit of culture.Women are significantly more likely to experience UTI than men. Nearly 1 in 3 women will have had at least I episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience 1 UTI during their lifetime. Specific sub-populations at increased risk of UTI include infants, pregnant women, the elderly, patients with spinal cord injuries and/or catheters, patients with diabetes or multiple sclerosis, patients with acquired immunodeficiency disease syndrome/human immunodeficiency virus, and patients with underlying urologic abnormalities. Catheter-associated UTI is the most common nosocomial infection, accounting for >1 million cases in hospitals and nursing homes. The risk of UTI increases with increasing duration of catheterization. In noninstitutionalized elderly populations, UTIs are the second most common form of infection, accounting for nearly 25% of all infections.There are important medical and financial implications associated with UTIs. In the nonobstructed, nonpregnant female adult, acute uncomplicated UTI is believed to be a benign illness with no long-term medical consequences. However, UTI elevates the risk of pyelonephritis, premature delivery, and fetal mortality among pregnant women, and is associated with impaired renal function and end-stage renal disease among pediatric patients. Financially, the estimated annual cost of community-acquired UTI is significant, at approximately $1.6 billion.