Management of Urosepsis in 2018.

Despite optimal treatment, urosepsis has still high morbidity and mortality rates. An updated definition and classification system for sepsis have recently been introduced. Management of urosepsis comprises four major aspects: (1) early diagnosis, (2) early empiric intravenous antimicrobial treatment, (3) identification and control of complicating factors, and (4) specific sepsis therapy. The quick sequential organ failure assessment is replacing the systemic inflammatory response syndrome scoring for rapid identification of patients with urosepsis. PATIENT SUMMARY: Urosepsis is a serious, life-threatening complication of infections originating from the urinary tract. As urosepsis has a very high mortality rate, it is important that is quickly spotted and that appropriate treatment is swiftly begun. Imaging of urinary tract disorders has been shown to be useful in decreasing mortality from urosepsis, and in the future microbiology techniques may also prove useful. Given the severity of urosepsis and the associated risks, large efforts need to be made to prevent high-risk infections in hospitals with appropriate prevention measures, such as the early removal of catheters used whenever possible.

European urology focus. 2018 Nov 14 [Epub ahead of print]

Gernot Bonkat, Tomasso Cai, Rajan Veeratterapillay, Franck Bruyère, Riccardo Bartoletti, Adrian Pilatz, Béla Köves, Suzanne E Geerlings, Benjamin Pradere, Robert Pickard, Florian M E Wagenlehner

alta uro AG, Merian Iselin Klinik, Center of Biomechanics & Calorimetry, University Basel, Basel, Switzerland. Electronic address: ., Department of Urology, Santa Chiara, Reg. Hospital, Trento, Italy., Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK., Academic Department of Urology, Pitié-Salpêtrière Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France., Department of Urology, University of Florence, Florence, Italy., Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Giessen, Germany., Department of Urology, South-Pest Teaching Hospital, Budapest, Hungary., Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Academic Medical Center, Amsterdam, The Netherlands., Newcastle University, Newcastle upon Tyne, UK.