This is the 3720th article of Da Medical Care
Urological outpatient clinics often have patients with urinary tract infections, but for different infected patients, clinicians have great differences in terms of examination methods, treatment methods and preventive measures. Xiao Zhang because of the Spring Festival often overtime, overwork, there is a feeling of urinary discomfort, the doctor only gave her a urine routine, and urinary ultrasound examination, diagnosed as a urinary tract infection, tell attention to rest, drink more water, oral antibacterial drugs for 3 days, the symptoms disappeared; but the next door Aunt Wang is also because of urinary discomfort, repeated attacks of low back pain, to the specialist clinic for treatment, doctor diagnosis: for complex urinary tract infections, but also admitted to the hospital, why is this?
What is a complicated urinary tract infection? Clinical urinary tract infections, there is a distinction between simplicity and complexity, complex urinary tract infections as the name suggests: that is, the cause of the urinary tract infection is more complex; these patients may have: urinary tract system anatomy or dysfunction (such as obstruction, stones, abnormal ureteral function, urinary tract surgery, urinary tumors undergo chemotherapy or other treatment, etc.); or have extrarenal disease (such as diabetes, blood diseases, immunodeficiency diseases, long-term use of drugs that damage renal function); their disease history is long, It is a state of recurrent or continuous seizures, which can easily lead to different degrees of damage to kidney function. Clinical bacteriological examination, can find that the pathogenic bacteria causing infection are also more complex, there are some special patients, due to the disease need indwelling urinary catheter, ureteral stent tube, due to difficulty urination, residual urine volume, may require intermittent self-catheterization, etc.;
Therefore, the treatment of urinary tract infections in such patients requires not only effective control of infection symptoms, but also to find possible causes of infection, which we call:"triggers".
Complications of complicated urinary tract infections are more common, and in severe cases, they can cause systemic infection or renal failure. Some triggers, such as urinary stones, abscesses, etc. can be solved by surgery, and some urinary tract infections associated with diabetes, nervous system, blood system diseases and other related chronic diseases need to be found in controlling chronic diseases, reducing the number of diseases and reducing the degree of infection, maintaining a better urinary environment and better protecting kidney function. In the treatment of antibiotic drugs, it is also necessary to pay attention to the choice of effective antibiotics, most of which have a long history of infection, recurrent seizures, and long-term use of antibiotics, making the body prone to drug-resistant bacteria, so the risk of treatment failure is higher.
Therefore, for people with a high incidence of complicated urinary tract infections, our recommendations are: prevention first, actively correct the lesions of the urinary system, control chronic diseases, and improve autoimmunity; precision treatment, when symptoms of urinary tract infection occur, first keep urine samples, bacteriological culture, and clarify the types of infectious bacteria and sensitive antibiotics, so that clinicians can be correctly guided to choose effective antibiotics and avoid the toxic side effects caused by blind medication.
Author: Shanghai Public Health Clinical Center
Urology Bao Juan