Pathogenesis of urinary tract infection

2017 ◽  
Author(s):  
Ased Ali
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Infection ◽  
Asymptomatic Bacteriuria ◽  
Uropathogenic Escherichia Coli ◽  
Systemic Sepsis ◽  
Molecular Pattern ◽  
Clinical Consequences ◽  
Minor Infection

The realization of the harms resulting from indiscriminate use of antibiotics for minor infection has added impetus to the need to understand better the interaction between urogenital tract epithelium and invading bacteria during the initial stages of urinary tract infection (UTI). It is thought that uropathogenic Escherichia coli clones develop in the gut and migrate across the perineum to the urethra and up into the bladder. The response of the epithelium to bacterial adherence and the evolution of the invading bacteria will then govern the clinical consequences. These can vary between rapid invasion and further migration to produce systemic sepsis to tolerance of the bacteria in a planktonic state in asymptomatic bacteriuria. The key to these differences is the activation of epithelial pathogen-associated molecular pattern receptors by expressed proteins on the bacterial cell wall. Increased understanding of these interactions will lead to non-antibiotic-based strategies for clinical management of urinary infection.

scholarly journals Postoperative urinary tract infection after ureteroscopic lithotripsy in patients with asymptomatic bacteriuria

2020 ◽  
Vol 77 (9) ◽  
pp. 917-922
Author(s):  
Mirko Jovanovic ◽  
Vesna Suljagic ◽  
Vladimir Bancevic
Keyword(s):  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Infection ◽  
Asymptomatic Bacteriuria ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Ureteroscopic Lithotripsy ◽  
Infective Complications

Background/Aim. Postoperative urinary tract infection (UTI) is one of the most common infective complications of ureteroscopic lithotripsy. Preoperative asymptomatic bacteriuria is not a contraindication for performing ureteroscopic lithotripsy but it can be a significant risk factor for occurrence of severe forms of postoperative urinary infection. Methods. From January 2010 until December 2014 at the Urology Clinic of the Military Medical Academy in Belgrade, 389 patients undergoing ureteroscopic lithotripsy were analyzed, and their postoperative infective complications were monitored. From the group, the incidence of posteoperative urinary infection was analysed in 52 patients with preoperative asymptomatic bacteriuria. Results. Infective complications occured in 18.7% of patients, and postoperative UTI in 10% of patients. Out of 52 patients with preoperative asymptomatic bacteriuria, 36.5% had postoperative urinary tract infection (?2 = 46.773; p < 0.001). In these patients, we registered higher frequency of severe forms of postoperative UTI, systemic inflammatory response syndrome (SIRS) and sepsis. Conclusion. Preoperative asymptomatic bacteriuria represents a significant risk factor for developing postoperative UTI following ureteroscopic lithotripsy and is associated with increased risk for occurence of severe forms of SIRS and sepsis. It is desirable that every patient with indicated ureteroscopic lithotripsy has sterile urine culture, and if this is impossible to achieve, a special caution and an adequate antibiotic therapy and prophylaxis are needed before and during the surgical procedure

scholarly journals Complicated Urinary Tract Infection in Adults

2005 ◽  
Vol 16 (6) ◽  
pp. 349-360 ◽  
Author(s):  
LE Nicolle
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Therapy ◽  
Current Knowledge ◽  
Urinary Infection ◽  
Asymptomatic Bacteriuria ◽  
Complicated Urinary Tract Infection ◽  
Urine Specimen ◽  
Infecting Organisms

BACKGROUND: Complicated urinary tract infection occurs in individuals with functional or structural abnormalities of the genitourinary tract.OBJECTIVE: To review current knowledge relevant to complicated urinary tract infection, and to provide evidence-based recommendations for management.METHODS: The literature was reviewed through a PubMed search, and additional articles were identified by journal reference review. A draft guideline was prepared and critically reviewed by members of the Association of Medical Microbiology and Infectious Disease Canada Guidelines Committee, with modifications incorporated following the review.RESULTS: Many urological abnormalities may be associated with complicated urinary infection. There is a wide spectrum of potential infecting organisms, and isolated bacteria tend to be more resistant to antimicrobial therapy. Morbidity and infection outcomes in subjects with complicated urinary infection are principally determined by the underlying abnormality rather than the infection. Principles of management include uniform collection of a urine specimen for culture before antimicrobial therapy, characterization of the underlying genitourinary abnormality, and nontreatment of asymptomatic bacteriuria except before an invasive genitourinary procedure. The antimicrobial regimen is determined by clinical presentation, patient tolerance, renal function and known or anticipated infecting organisms. If the underlying abnormality contributing to the urinary infection cannot be corrected, then early post-treatment recurrence of infection is anticipated.CONCLUSIONS: The management of complicated urinary infection is individualized depending on patient variables and the infecting organism. Further clinical investigations are necessary to assist in determining optimal antimicrobial regimens.

scholarly journals Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

2017 ◽  
Vol 31 (4) ◽  
pp. 673-688 ◽  
Author(s):  
Nicolas W. Cortes-Penfield ◽  
Barbara W. Trautner ◽  
Robin L.P. Jump
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria

Impact of an Antimicrobial Stewardship Care Bundle to Improve the Management of Patients with Suspected or Confirmed Urinary Tract Infection

2016 ◽  
Vol 37 (12) ◽  
pp. 1499-1501 ◽  
Author(s):  
Curtis D. Collins ◽  
Jared J. Kabara ◽  
Sarah M. Michienzi ◽  
Anurag N. Malani
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Asymptomatic Bacteriuria ◽  
Care Bundle ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program ◽  
Bundle Compliance ◽  
Tract Infections

Implementation of an antimicrobial stewardship program bundle for urinary tract infections among 92 patients led to a higher rate of discontinuation of therapy for asymptomatic bacteriuria (52.4% vs 12.5%; P =.004), more appropriate durations of therapy (88.7% vs 63.6%; P =.001), and significantly higher overall bundle compliance (75% vs 38.2%; P < .001).Infect Control Hosp Epidemiol 2016;1499–1501

scholarly journals Diagnosis of Urinary Tract Infection in the Neuropathic Bladder: Changing the Paradigm to Include the Microbiome

2019 ◽  
Vol 25 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Catherine S. Forster ◽  
Hans Pohl
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Management ◽  
Significant Variation ◽  
Asymptomatic Bacteriuria ◽  
Specific Term ◽  
Variation In Care ◽  
Urinary Microbiome ◽  
Definition Of

Bacteriuria, a non-specific term that refers to the presence of bacteria in the urine, is common in people with neuropathic bladders. However, accurately determining when bacteriuria represents a urinary tract infection (UTI) as opposed to asymptomatic bacteriuria is difficult. There is currently no widely accepted definition of what constitutes a UTI in people with neuropathic bladders. As a result, there is significant variation in care, which likely leads to unnecessary use of antibiotics for bacteriuria. To improve the clinical management of people with neuropathic bladders, it is important to be able to accurately diagnose and treat UTIs. In this article, we review the difficulties associated with accurately diagnosing UTIs and then review proposed definitions. Finally, we discuss the emerging literature of the urinary microbiome and how this may assist in accurately diagnosing UTIs in people with neuropathic bladders.

scholarly journals CAPSULE PRODUCTION PATTERN OF UROPATHOGENIC ESCHERICHIA COLI OF URINARY TRACT INFECTION PATIENTS IN KIRKUK HOSPITALS

2020 ◽  
Vol 17 (35) ◽  
pp. 621-627
Author(s):  
May Ali Hussien UMRAN ◽  
Sumaya Najim AL-KHATEEB
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Manifestations ◽  
Uropathogenic Escherichia Coli ◽  
E Coli ◽  
Intestinal Pathogens ◽  
Production Pattern ◽  
Living Organisms

The bacterium Escherichia coli is one of the best free-living organisms studied in depth. It is a surprisingly diverse species, since some strains of E. coli live in the intestine of animals as harmless commensals, while other distinct genotypes, such as an enteropathogenic or enterohemorrhagic E. coli, for example, cause morbidity and death marked as human intestinal pathogens. The purpose of this study was to develop and validate a PCR assay for a known and suspected uropathogenic E. coli virulence factor (kpsMT) gene region to determine the distribution of the gene and its role in the development of clinical diseases of the urinary system. A total of 25 urine samples were collected from patients with urinary tract infection (UTI) at Azadi and Kirkuk hospitals in the city of Kirkuk, Iraq. Samples of both genders and different ages were collected from patients with suspected urinary tract infection according to the clinical manifestations and symptoms diagnosed by the examining physician. The samples were cultured and positive samples were subjected to the IMViC test to identify E. coli bacteria and subsequently identified using the Vitek 2 compact system. Among 25 samples, 24 (96%) showed positive results for bacterial cultural growth. Of these, 17 (68%) were identified as Escherichia coli. Of the total of 17 isolates, 14 from patients with mild urinary tract infection, and 3 from patients with Urosepsis. The kpsMT gene was present in 14 isolates (82.3%), including 11 (78.5%) isolates from patients with mild urinary tract infection, and 3 (100%) isolates from patients with Urosepsis. It was concluded that Escherichia coli is the most prevalent in urine tract infection samples. Due to the abundance of the kpsMT gene in uropathogenic Escherichia coli (UPEC), this gene plays an important role in developing UTI if it is not treated correctly and quickly; mild cases of UTI can turn into Urosepsis.

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