https://www.vdl.ndsu.edu/wp-content/uploads/2022/02/ISCAID-Urinary-Guidelines-2019.pdf
https://www.iscaid.org/wp-content/uploads/2013/10/Urinary-guidelines.pdf
Subclinical bacteriuria
- 임상증상없다면 필요하지않아.
- 꽤 흔해. 기저질환없이다. 당뇨, 비만, 파보장염걸렸거나, 디스크탈출증있거나 마비된애들 (gcc, csa 치료받는)
- ascending 혹은 전신감염 위험이 높은 면역억압된 환자나 underlying renal diz 있는 환자에서는 치료해.
- 혹은 extraurinary infection 이 원인일것같을때.
- 기저질환 찾아서 해결하는게 중요하며, 치료는 올바른 진단 대신에 시행되어서는 안됨.
- MRB (multidrug resistant bacterium_) 의심된다면, 이거 자체로도 치료대상일수도있아.
- 저항성가진 병균이, 저항성없는 병균을 대체할수있다는 기록이있거든.
그런데, 결석형성하는 애들 ureas pruductcing staphylococci 는 치료해야.
Treatment of subclinical bacteriuria caused by plaqueforming (Corynebacterium urealyticum) and urease-producing (e.g. staphylococci) organisms could be considered
because of their associations with encrusting cystitis and
struvite urolith formation, respectively (Bailiff et al., 2005;
Biegen et al., 2013; López-Medrano et al., 2008; Raab et al.,
2015). Because of the potential difficulties in treating these
conditions, consideration of a single short course (3–5 days
duration) of treatment, as per ‘Sporadic bacterial cystitis’,
could be considered after confirming that bladder wall plaque
or uroliths are not present. However, it is unknown whether
this is a necessary or effective approach. Continued treatment
of subclinical bacteriuria with these strains is likely not
warranted
. Further evidence for current ISCAID guideline contraindication for SB treatment due to HC were provided.
