Signifikante Bakteriurie der Katze: bakterielle Harnwegsinfektion und subklinische Bakteriurie

Zusammenfassung

Bei Harnwegsinfektionen (HWI) handelt es sich um die Anheftung und Multiplikation von Erregern im Harntrakt. Acht bis 19 % der Katzen mit klinischen Symptomen einer Erkrankung der unteren Harnwege leiden an einer HWI. Bei Katzen mit einer subklinischen Bakteriurie kann eine signifikante Anzahl an Bakterien im Urin nachgewiesen werden, obwohl keine entsprechenden Symptome vorliegen. Die Prävalenz der subklinischen Bakteriurie in der Katzenpopulation beträgt 1–29 %. Neben dem am häufigsten isolierten Uropathogen Escherichia coli werden oft Streptokokken, Enterokokken und Staphylokokken nachgewiesen. Harnwegsinfektionen sind ein häufiger Grund für den Einsatz von Antibiotika. Um der zunehmenden Resistenzentstehung vorzubeugen, sollte ein Antibiotikum mit möglichst engem Wirkspektrum basierend auf den Ergebnissen der Kultur und des Antibiogramms gewählt werden. Aktuell ist die Studienlage zur Behandlung der subklinischen Bakteriurie unzureichend. Die meisten Experten empfehlen, nur Patienten mit einem erhöhten Risiko aufsteigender Infektionen antibiotisch zu behandeln.

Summary

Urinary tract infection (UTI) refers to the adherence and multiplication of an infectious agent within the urinary system. In 8–19 % of cats with clinical signs of lower urinary tract disease, bacterial UTI is identified as a cause. Subclinical bacteriuria is defined as the isolation of a significant number of bacteria in a urine specimen obtained from a patient without symptoms related to UTI. Subclinical bacteriuria has been reported in 1–29 % of cats. The most commonly isolated pathogen in feline urine is Escherichia coli. Other frequently isolated microorganisms are Streptococcus species (spp.), Enterococcus spp. and Staphylococcus spp. Antimicrobials are frequently used to treat UTIs. To prevent the development of antibiotic resistance, results of urine culture and susceptibility testing should be first obtained and antimicrobials with a narrow spectrum of activity should be used. Currently, there is insufficient evidence as to whether subclinical bacteriuria in cats should be treated or not. However, treatment of subclinical bacteriuria is only recommended in patients with an increased risk of ascending infections.

Schlüsselwörter

Zystitis - feline lower urinary tract disease (FLUTD) - asymptomatische Bakteriurie - Antibiotika - Resistenzen

Keywords

Cystitis - feline lower urinary tract disease (FLUTD) - asymptomatic bacteriuria - antimicrobial susceptibility - antimicrobial resistance - feline

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