Infecciones del tracto urinario

  1. Yuste, Jose Ramon
  2. del Pozo, J.L.
  3. Carmona-Torre, F.
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2018

Título del ejemplar: Enfermedades infecciosas (III) Infecciones por bacilos Gram negativos

Serie: 12

Número: 51

Páginas: 3020-3030

Tipo: Artículo

DOI: 10.1016/J.MED.2018.03.004 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

Resumen Introducción. Las infecciones del tracto urinario (ITU) son una de las enfermedades infecciosas más frecuentes tanto en el ámbito ambulatorio como en el hospitalario, en este último caso, principalmente relacionado con la presencia de catéteres urinarios. Patogenia y manifestaciones clínicas. Las infecciones urinarias se producen por vía ascendente de un uropatógeno que coloniza la mucosa periuretral, habitualmente procedente del intestino. Principalmente se manifiestan con un síndrome miccional. La mayoría de las ITU son infecciones no complicadas que se presentan en mujeres jóvenes, sexualmente activas. Las infecciones de vía urinaria alta-parenquimatosas entre las que incluyen aquellas infecciones que afectan a parénquima-pelvis renal y/o próstata se pueden producir por vía ascendente o por vía hematógena y clínicamente suelen asociar un síndrome infeccioso. Diagnóstico y tratamiento. El diagnóstico se basa fundamentalmente en la clínica y el cultivo de orina. El hemocultivo solo se recomienda en determinadas situaciones y, en la mayoría de los casos, no se requieren pruebas diagnósticas complementarias. El tratamiento habitualmente se puede realizar de modo ambulatorio y se establece de forma empírica, de acuerdo con el patrón local de sensibilidad de Escherichia coli, que es el agente causal de más del 80% de estas infecciones. La bacteriuria asintomática (BA) y las ITU complicadas son otras formas de presentación de la ITU.

Referencias bibliográficas

  • De Cueto M, Aliaga L, Alós JI, Canut A, Los-Arcos I, Martínez JA. Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC). Enferm Infecc Microbiol Clin. 2017;35(5):314-20.
  • Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103-20.
  • Nicolle LE. Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urol Clin North Am. 2008;35:1-12.
  • Lane DR, Takhar SS. Diagnosis and management of urinary tract infection and pyelonephritis. Emerg Med Clin North Am. 2011;29:539-52.
  • Pigrau C. Nocosomial urinary tract infections. Enferm Infecc Microbiol Clin. 2013;31:614-24.
  • Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40:643-54.
  • Naber KG, Schito G, Botto H, Palou J, Mazzei T. Surveillance study in Europe and Brazil on clinical aspects and Antimicrobial Resistance Epidemiology in Females with Cystitis (ARESC): implications for empiric therapy. Eur Urol. 2008; 54:1164-75.
  • Andreu A, Planells I. Etiology of community acquired lower urinary infections and antimicrobial resistance of Escherichia coli: a national surveillance study. Med Clin (Barc). 2008;130:481-6.
  • Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clin Infect Dis. 2004;38:1150-8.
  • Palou J, Pigrau C, Molina I, Ledesma JM, Angulo J. Etiology and sensitivity of uropathogens identified in uncomplicated lower urinary tract infections in women (ARESC Study): implications on empiric therapy. Med Clin (Barc). 2011;136:1-7.
  • Pigrau C. Recurrent urinary infections: predisposing factors and prevention strategies. Urinary tract infection. Oxford: Oxford University Press; 2013. p. 85-104.
  • Nicolle LE. Complicated urinary tract infection in adults. Can J Infect Dis Med Microbiol. 2005;16:349-60.
  • Broseta E. Clasificación, diagnóstico y manejo terapéutico de las prostatitis. Urinary tract infection. Oxford: Oxford University Press; 2013. p. 105-20.
  • Nicolle LE. Urinary catheter associated infections. Infect Dis Clin North Am. 2012;26:13-27.
  • Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012;366:1028-37.
  • Hooton TM. The current management strategies for community acquired urinary tract infection. Infect Dis Clin North Am. 2003;17:303-32.
  • Gomi H, Goto Y, Laopaiboon M, Usui R, Mori R. Routine blood cultures in the management of pyelonephritis in pregnancy for improving outcomes. Cochrane database Syst Rev. 2015;2:CD009216.
  • Smaill FM, Vázquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane database Syst Rev. 2015;8:CD000490.
  • Nicolle LE. Management of asymptomatic bacteriuria in pregnant women. Lancet Infect Dis. 2015;15:1252-4.
  • Pregazzi R, Mazzatenta E, Bouchè C. [Single dose antibiotic therapy of asymptomatic bacteriuria in pregnancy. Results and complications]. Minerva Ginecol. 1987;39:289-92.
  • Yang L, Gao L, Chen Y, Tang Z, Liu L, Han P. Prophylactic antibiotics in prostate biopsy: A meta-analysis based on randomized controlled trials. Surg Infect (Larchmt). 2015;16:733-47.
  • Zani EL, Clark OAC, Rodrigues Netto N. Antibiotic prophylaxis for transrectal prostate biopsy. Cochrane database Syst Rev. 2011;(5):CD006576.
  • McQuiston Haslund J, Rosborg Dinesen M, Sternhagen Nielsen AB, Llor C, Bjerrum L. Different recommendations for empiric first choice antibiotic treatment of uncomplicated urinary tract infections in Europe. Scand J Prim Health Care. 2013;31:235-40.
  • Knottnerus BJ, Grigoryan L, Geerlings SE, Moll van Charante EP, Verheij TJM, Kessels AGH. Comparative effectiveness of antibiotics for uncomplicated urinary tract infections: network meta-analysis of randomized trials. Fam Pract. 2012;29:659-70.
  • Rafalsky V, Andreeva I, Rjabkova E. Quinolones for uncomplicated acute cystitis in women. Cochrane database Syst Rev. 2006;CD003597.
  • Llor C, Aspiroz C, Cano A, Barranco M. The use of amoxicillin and clavulanic acid and quinolones the first choice antibiotics in uncomplicated urinary tract infections in Spain should be reviewed. Primary School. 2012;44:443-4.
  • Leone M, Perrin A-S, Granier I, Visintini P, Blasco V, Antonini F. A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients. Intensive Care Med. 2007;33:726-9.
  • Tenke P, Köves B, Johansen TEB. An update on the prevention and treatment of catheter-associated urinary tract infections. Curr Opin Infect Dis. 2014;27:102-7.
  • Kula B, Djordjevic G, Robinson JL. A systematic review: Can one prescribe carbapenems to patients with IgE-mediated allergy to penicillins or cephalosporins? Clin Infect Dis. 2014;59:1113-22.
  • Horcajada JP, Shaw E, Padilla B, Painted V, Calbo E, Benito N. Healthcare associated, community acquired and hospital acquired bacteraemic urinary tract infections in hospitalized patients: a prospective multicohort study in the era of antimicrobial resistance. Clin Microbiol Infect. 2013;19:962-8.
  • Rodríguez-Baño J, Cisneros JM, Cobos-Trigueros N, Fresco G, Navarro-San Francisco C, Gudiol C. Diagnosis and antimicrobial treatment of invasive infections due to multidrug resistant Enterobacteriaceae. Guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology. Enferm Infecc Microbiol Clin. 2015;33:337.e1-337.e21.
  • Paul M, Lador A, Grozinsky-Glasberg S, Leibovici L. Beta lactam antibiotic monotherapy versus beta lactamaminoglycoside antibiotic combination therapy for sepsis. Cochrane database Syst Rev. 2014;1:CD003344.
  • Wagenlehner FM, Umeh O, Steenbergen J, Yuan G, Darouiche RO. Ceftolozanetazobactam compared with levofloxacin in the treatment of complicated urinary tract infections, including pyelonephritis: a randomized, double-blind, phase 3 trial (ASPECT-cUTI). Lancet. 2015;385:1949-56.
  • Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane database Syst Rev. 2012;10:CD001321.
  • Kranjcec B, Papeš D, Altarac S. Dmannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol, 2014;32:79-84.
  • Perrotta C, Aznar M, Mejia R, Albert X, Ng CW. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane database Syst Rev. 2008;(2):CD005131.
  • Taha Neto KA, Nogueira Castilho L, Reis LO. Oral vaccine (OM-89) in the recurrent urinary tract infection prophylaxis: a realistic systematic review with meta-analysis. Actas Urol Esp. 2016; 40: 203-8.
Fuente de los datos: Dialnet