目的:这是一项Delphi研究,旨在探索关于下尿路感染(UTI)现有文献证据中开放性问题的专家共识。本手稿涉及成年人,并分析了该主题的最新指南和荟萃分析。
方法:一组领先的泌尿科医师和泌尿外科医师参加了一个共识形成项目,使用德尔菲方法就复发性较低UTIns(rUTI)的灰色地带问题达成共识,孕妇无症状菌尿(AB),和成人导管相关尿路感染(CAUTI)。邀请所有小组成员参加四个阶段的共识。共识被定义为≥75%的协议。使用序数(0-10)。对rUTI的诊断检查和预防进行了系统的文献综述,AB,还有CAUTI.
结果:总计,37名专家参加了会议。所有小组成员都参加了协商一致进程的四个阶段。如果≥75%的专家就拟议的主题达成共识,则达成共识。在线会议和面对面共识会议于2023年3月在米兰举行。对12/13项目达成了正式共识。
结论:这份手稿是对专家的德尔菲调查,对rUTI的一些有争议的观点表现出兴趣,AB在怀孕期间,和预防CAUTI。关于非抗生素预防UTI和CAUTI的数据仍然很少;已经报道了关于妊娠AB的相当古老的研究。新出现的抗生素耐药性问题是相关的,非抗生素预防可能在其预防中起作用。
OBJECTIVE: This is a Delphi study that aims to explore expert consensus regarding open questions in current literature evidence on lower urinary tract infections (UTIs). This manuscript deals with adults and analyzed the most recent
guidelines and meta-analysis on the topic.
METHODS: A panel of leading urologists and urogynaecologists participated in a consensus-forming project using a Delphi method to reach consensus on gray zone issues on recurrent lower UTIns (rUTIs), asymptomatic bacteriuria (AB) in pregnant women, and catheter-associated UTIs (CAUTI) in adults. All the panelists were invited to participate the four phases
consensus.
Consensus was defined as ≥75% agreement. An ordinal scale (0-10) was used. A systematic literature review was analyzed for diagnostic workup and prevention of rUTIs, AB, and CAUTI.
RESULTS: In total, 37 experts participated. All panelists participated in the four phases of the
consensus process. Consensus was reached if ≥75% of the experts agreed on the proposed topic. Online meetings and a face-to-face consensus meeting was held in Milan in March 2023. Formal
consensus was achieved for 12/13 items.
CONCLUSIONS: This manuscript is a Delphi survey of experts that showed interest on some debated points on rUTIs, AB in pregnancy, and prevention of CAUTI. There is still little data on nonantibiotic prevention of UTIs and CAUTI; quite old studies have been reported on AB in pregnancy. The emerging problem of antibiotic resistance is relevant and nonantibiotic prophylaxis may play a role in its prevention.