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中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (02): 133 -137. doi: 10.3877/cma.j.issn.2096-1537.2017.02.011

所属专题: 重症医学 文献资源库

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导管相关泌尿系感染的各种诊断标准:哪一个更适合重症监护病房?
丁仁彧 1, 马晓春 1 , ( )   
  1. 1. 110001 沈阳,中国医科大学附属第一医院重症医学科
  • 收稿日期:2017-01-08 出版日期:2017-05-28
  • 通信作者: 马晓春

Varied diagnostic criteria for catheter-associated urinary tract infection: what is valid for ICU patients?

Renyu Ding 1, Xiaochun Ma 1 , ( )   

  1. 1. Department of Critical Care Medicine, The First Hospital of China Medical University, Shenyang 110001, China
  • Received:2017-01-08 Published:2017-05-28
  • Corresponding author: Xiaochun Ma
  • About author:
    Corresponding author: Ma Xiaochun, Email:

导管相关尿路感染(CAUTI)是重症监护病房(ICU)常见的一种医院获得性感染。现有较多CAUTI的临床诊断标准,包含了临床症状及微生物学参数。因为有很多原因使得ICU患者很难表述传统的尿路感染症状,对于ICU患者,有症状的CAUTI的诊断尤为困难,此外,仍缺乏区分定植和感染的可靠的实验室检测方法。然而,由于临床结局的不良,存在高危因素、并有原因不明发热症状的可疑CAUTI患者更应受到关注。现阶段美国感染病学会-2009以及美国国家医疗保健安全网和美国国家疾病控制中心-2015指南所给出的CAUTI的诊断标准可能更适合ICU患者。但CAUTI诊断标准的有效性仍是当今ICU日常临床实践中的重要问题。

Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections in intensive care units (ICUs). Previously, varied diagnostic criteria for CAUTI were published, which were mainly based on a combination of clinical and microbiological parameters. However, the diagnosis of symptomatic CAUTI might be particularly difficult in critically ill patients because typical symptoms of urinary tract infection such as urgent or frequent urination, were often masked by an impaired level of consciousness. Moreover, reliable diagnostic tests for distinguishing colonization from infection were not available yet. However, patients who are complicated with unaccountable fever and exposed to high risk factors of CAUTI (i.e.CAUTI was highly suspected) need to be seriously concerned in ICU owing to a deleterious outcome. IDSA-2009 and NHSN/CDC-2015 guidelines for diagnosis of CAUTI are likely more suitable for ICU patients. However, at present, validity of diagnostic criteria for CAUTI remains a big problem in our routine practices in ICU.

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