Bakterielle Harnwegsinfektion und subklinische Bakteriurie des Hundes: eine aktuelle Übersicht

Julia Harrer; Roswitha Dorsch

doi:10.1055/a-1220-1950

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2020; 48(04): 270-284
DOI: 10.1055/a-1220-1950

Übersichtsartikel

Bakterielle Harnwegsinfektion und subklinische Bakteriurie des Hundes: eine aktuelle Übersicht

Bacterial urinary tract infection and subclinical bacteriuria in the dog: a current review

Julia Harrer

Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München

,

Roswitha Dorsch

Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München

› Author Affiliations

Abstract

Zusammenfassung

Bakterielle Harnwegsinfektionen (HWI) treten bei Hunden häufig auf und stellen eine häufige Indikation für den Einsatz von Antibiotika in der tierärztlichen Praxis dar. Bei HWI kommt es zum Anhaften, zur Vermehrung und Persistenz von Infektionserregern im Harntrakt. Durch die Gewebsinvasion wird eine Entzündungsreaktion ausgelöst, die mit klinischen Symptomen einhergeht. Je nach Lokalisation der Infektion erfolgt eine Einteilung in bakterielle Zystitis, Prostatitis oder Pyelonephritis. Davon abzugrenzen ist die subklinische Bakteriurie (SB). Diese liegt vor, wenn aus einer adäquat gewonnenen Urinprobe eine signifikante Anzahl an Bakterien isoliert werden kann, das Tier jedoch keine klinischen Symptome einer Harnwegserkrankung zeigt. HWI entstehen in aller Regel durch aufsteigende Infektion mit Bakterien aus der wirtseigenen fäkalen oder distalen urogenitalen Flora. Escherichia coli ist dabei sowohl bei Hunden mit HWI als auch bei Hunden mit SB das häufigste Isolat. Die Diagnose basiert auf den klinischen Symptomen und den Befunden der Urinuntersuchung und -kultur. Ausführliche Therapieempfehlungen finden sich in den kürzlich überarbeiteten Richtlinien der International Society for Companion Animal Infectious Diseases, die im Folgenden zusammengefasst werden. Das Befolgen solcher Richtlinien steigert nicht nur den Therapieerfolg, sondern leistet auch einen Beitrag zur Eindämmung der Antibiotikaresistenzen.

Abstract

Bacterial urinary tract infection (UTI) is a common clinical presentation in dogs and a frequent reason for the prescription of antimicrobial drugs. UTI refers to adherence, multiplication and persistence of an infectious agent within the urogenital system. This causes an associated inflammatory response as well as the pertaining clinical signs. Depending on the site of infection, UTI’s may be classified as bacterial cystitis, prostatitis or pyelonephritis. In contrast, subclinical bacteriuria (SB) is defined as the presence of a significant number of bacteria in the urine of an individual not showing clinical signs referrable to UTI. UTI’s typically occur as a consequence of ascending pathogen migration from the host’s own fecal or distal urogenital microbial flora. The most commonly isolated pathogen in cases of UTI and SB is Escherichia coli. The diagnosis is based on clinical signs and the results of urine examination and culture. The recently revised guidelines of the International Society for Companion Animal Infectious Diseases provide detailed recommendations for diagnosis and management of different forms of bacterial UTI’s in dogs. Adherence to treatment guidelines will improve treatment success and is imperative in avoiding further deterioration of the antimicrobial resistance situation.

Schlüsselwörter

Kanin - Zystitis - Pyelonephritis - Prostatitis - Antibiotika

Key words

Canine - cystitis - pyelonephritis - prostatitis - antimicrobials

Full Text

References

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