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Der Urologe

, Volume 56, Issue 6, pp 734–745 | Cite as

Rezidivierende und katheterassoziierte Harnwegsinfektionen

Prophylaxe und Prävention
Leitthema

Zusammenfassung

Harnwegsinfektionen (HWI) haben als eine der häufigsten bakteriellen Infektionen in der Humanmedizin eine große Bedeutung. Wegen der steigenden Prävalenz multiresistenter Erreger sollte zur Diagnostik stets eine Urinkultur angelegt werden, um den ungezielten Einsatz von Antibiotika zu vermeiden. Zur Prophylaxe rezidivierender HWI der Frau stehen nach dem Ausschluss prädisponierender Faktoren heute eine Vielzahl verhaltenstherapeutischer, medikamentöser und supportiver Behandlungsoptionen zur Verfügung. Dabei haben Vakzinen, Probiotika (Laktobazillen) und standardisierte Phytopharmaka vor dem Hintergrund der Antibiotikaresistenzentwicklung einen wachsenden Stellenwert. Nosokomiale HWI sind zu 80 % mit einem Harnwegskatheter assoziiert. Es wird davon ausgegangen, dass bis zu 70 % dieser Infektionen durch geeignete Präventionsmaßnahmen verhindert werden können. Fundierte Kenntnisse der Grundlagen harnwegskatheterassoziierter Infektionen (HKI) und der korrekte Umgang mit Harnwegskathetern haben deshalb nicht nur eine große individuelle sondern auch sozioökonomische Bedeutung.

Schlüsselwörter

Immunisierung Probiotika Phytopharmaka Katheter Infektion, bakterielle 

Recurrent and catheter-associated urinary tract infections

Prophylaxis and prevention

Abstract

Urinay tract infection (UTI) as one of the most frequent bacterial infections in humans is of utmost relevance. Because of the rising prevalence of antimicrobial resistance, urinalysis should always include urine culture and a resistogram in order to avoid an unspecific selection and overuse of antibiotics. Prevention of recurrent UTI must first of all rule out predisposing uropathogenic conditions. Nowadays, a great variety of drugs, behavioral, and supportive treatment options can effectively minimize UTI recurrence. The growing importance of vaccines (immunotherapy), probiotics (lactobacilli), and standardized herbal preparations meets the need of reducing antibiotic use and the development of antimicrobial resistance. Around 80% of all nosocomial UTIs (nUTIs) are associated with indwelling urinary catheters. It is estimated that up to 70% of all nUTIs occurring in Germany may be avoided by using appropriate preventative measures. Therefore, profound knowledge about the basics of catheter-associated nUTIs and the correct management of urinary catheters are of utmost individual and socioeconomic importance.

Keywords

Vaccines Probiotics Herbal medicines Catheter Infection, bacterial 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

H. Piechota gibt folgenden Interessenkonflikt an: Medizinische Fachberatung für Bionorica SE und Teleflex Medical GmbH.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Klinik für Urologie, Kinderurologie und Operative Uro-Onkologie, Johannes Wesling-Klinikum MindenUniversitätsklinikum der Ruhr-Universität BochumMindenDeutschland

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