Recurrent urinary tract infections in adults: a practical guide

Recurrent urinary tract infections are a common problem faced by clinicians across many specialities. For the patient, recurrent urinary tract infections can be burdensome and detrimental to their quality of life. For the clinician, they can be challenging to manage, and the socioeconomic burden on healthcare systems can also be substantial. Investigations serve to rule out any underlying structural or pathological abnormalities. In conjunction with behavioural prevention methods, treatment strategies include antibiotic and non-antibiotic approaches and holistic management approaches. This article provides an overview of the investigation and treatment of urinary tract infections and includes algorithms which can be used in daily clinical practice.

Features of the vaginal microbiota in recurrent urinary tract infections in childhood

BACKGROUND. Currently, there is a stable deterioration in the somatic health of preschool-age girls, which creates a real threat to the realization of reproductive function in the future. The state of vaginal microbiocenosis in preschool girls suffering from recurrent urinary tract infections (UTIs) remains a little-studied problem.THE AIM: to assess the state of the vaginal biotope in preschool girls suffering from recurrent UTIs.PATIENTS AND METHODS. 92 girls aged 3-6 years were examined, of which: group 1 (n=32) - patients with recurrent UTI; group 2 (n=30) - patients with rare UTI; group 3 (n=30) - girls of 1,2 health groups. Vaginal microbiocenosis was assessed by quantitative PCR using the «Femoflor-17 test system». Statistical analysis was performed using the application program "Statistica 6.0 for Windows".RESULTS. Facultative anaerobes predominate in the vaginal microbiocenosis of patients with UTI, the absolute content of which is significantly higher in patients with the recurrent course (p <0.05). The relative number of facultative anaerobes is significantly higher in patients with rare UTIs (p<0.05). In patients with recurrent UTI, the absolute and relative content of obligate anaerobes is lower than in patients with rare UTI and girls from the control group. The index of total bacterial mass in patients with UTI, compared with girls of the control group, is significantly higher (p<0.05). In patients with UTI, an increase in the colonies of the Enterobacteriacea family and a decrease in obligate anaerobes were determined in comparison with similar indicators of girls in the control group.CONCLUSION. The presence of recurrent UTI in preschool girls is a risk factor for the development of the severe vaginal dysbiotic condition. Rare UTIs can also be a risk of developing vaginal dysbiosis. Real-time multi-dimensional PCR provides quantitative and qualitative characteristics of the conditionally pathogenic flora of the vaginal biotope.