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By K. Ranco, E. Verrier

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Extra info for Advanced Therapy in Cardiac Surgery

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Therapie bei Keimnachweis 4 Behandlung symptomatischer HWI-Episoden siehe 7 Abschn. 2, 4 Suppressionstherapie (kontinuierliche Antibiotikagabe bei fehlender Sanierungsmöglichkeit des Infektherdes): 5 Indikation: am ehesten bei CP mit nicht komplett sanierbaren Infektharnsteinen oder häufigen symptomatischen Rezidiven, 5 umstritten bei persistierender Leukozyturie und asymptomatischer Bakteriurie, 5 bei normaler Nierenfunktion ggf. Hohlraumantiseptika wie Nitrofurantoin (1- bis 2-mal 100 mg) oder Nitroxolin (1- bis 2-mal 250 mg), um Resistenzprobleme zu vermeiden.

4 Wichtiger Hinweis für das Vorliegen einer IC ist eine erhöhte Nervenfaser- und Mastzelldichte und eine elektronenmikroskopisch nachweisbare Mastzellaktivierung in tiefen Biopsiepräparaten der Blase (subepithelial und in der Detrusormuskulatur); der fehlende Nachweis schließt die Diagnose aber nicht aus! Um die Diagnose IC zu stellen, ist eine Biopsie nicht erforderlich. Sie dient dem Ausschluss eines Carcinoma in situ. Kaliumsensibilitätstest nach Parsons 4 Der Test basiert auf der gestörten Permeabilität der Blasenschleimhaut mit Hypersensitivität der sensorischen Nerven.

2 Postmenopausale Zystitis Bentley DW, Bradley S, High K et al. (2000) Practice guideline for evaluation of fever and infection in long-term care facilities. Clin Infect Dis 31:640–653 Loeb M, Bentley DW, Bradley S et al. (2001) Development of minimum criteria for the initiation of antibiotics in residents of long-term care facilities. Results of a consensus conference. Infect Control Hosp Epidemiol 22:120–124 Nicolle LE, SHEA Long Term Care Committee (2001) Urinary tract infections in long term care facilities.

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Advanced Therapy in Cardiac Surgery by K. Ranco, E. Verrier

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