Urinary Tract Infection (UTI) Still a Force to be Reckoned with
Keywords:Escherichia coli, Klebsiella, Pseudomonas aeruginosa, Enterobacteriaceae, uncomplicated cystitis, , cefaclor
Burning pain ,frequent urge to urinate is the first sign of a UTI. It is due to bacteria in the urethra or bladder. Frequent urination is another red flag for an infection. Urine produces peculiar even foul odor and smoky, cloudy. Urine appears pinkish or reddish due to the presence of blood.Young women are commonly infected.Prostate hypertrophy is linked to male disease. It is affecting almost 4 million people in US alone. The chance of UTI is more in women.In females, it affects the bladder and urethra. Women who use diaphragms, spermicidal agents are more at risk. Menopause women are more vulnerable to infection. Infection of upper urinary tract,consisting of the kidney and pelvis ,is known as pyelonephritis.Infection of the lower tract may involve the bladder (Cystitis),urethra (Urethritis) or prostate (Prostatitis) Intercourse is common association of UTI. Catheters increase the risk.Obstruction of urinary flow increase the risk.Bacterial adherence favors persistence.Fever is usually absent.Enterobacteriaceae and gram positive bacteria appear with complications.Back and perirectal pain are the signs of UTI.Pyuria suggests UTI but not specific.Chronic disease is the source of cystitis.Kidney infection results in permanent kidney damage. Take plenty of water/fluids to flush out bacteria.Wipe front to back. This helps the spread of bacteria from the anus into the bladder. Decreased estrogen levels during menopause cause changes that make the urinary tract more susceptible to bacteria. Most patients with UTI have uncomplicated cystitis, which is one of the most common infections in the United States, especially in sexually active women. Escherichia coli is the most common cause of urinary tract infection. Staphylococcus saprophyticus is a frequent cause of cystitis in women, probably related to its occurrence as a part of normal vaginal flora. Klebsiella, Enterobacter, Proteus, and Serratia are the primary opportunistic and often nosocomial pathogens. Pseudomonas aeruginosa is an opportunistic pathogen and a major cause of hospital-acquired infections.
(1) Domingue, G. J. &Hellstrom, W. J. G. (1998). Prostatitis. Clin Microbiol Rev 11, 604–613.
(2) Dafnis E, Sabatini S: The effect of pregnancy on renal function: physiology and pathophysiology. Am J Med Sci 1992, 303(3):184-205.
(3) Bacak SJ, Callaghan WM, Dietz PM, Crouse C: Pregnancy-associated hospitalizations in the United States, 1999-2000. Am J ObstetGynecol2005, 192(2):592-597.
(4) Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, St.Geme JW III, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia (PA): Elsevier Saunders, 2016:2554-63.
(5) Wald ER. Cystitis and pyelonephritis. In: Feigin RD, Cherry J, Demmler-Harrison GL, Kaplan SL, editors. Feigin and Cherry’s text book of infectious diseases. 6th ed. Philadelphia (PA): Elsevier Saunders, 2009:554-69.
(6) Agace, W., Hedges, S., Andersson, U. et at.. (1993). Selective cytokine production by epithelial cells following exposure to Escherichia coll.Infection and Immunity ,61, (2), 602-609.
(7) Al Mamun, A. A. M., Tominaga, A. and Enomoto, M. (1996). Detection and characterization of the flagellar master operon in the four Shigella subgroups. Journal of Bacteriology 178: 3722-3726.
(8) Cheol-In Kang, Jieun Kim, Dae Won Park, Baek-Nam Kim, U-Syn Ha, Seung-Ju Lee,JeongKyun Yeo, Seung Ki Min, Heeyoung Lee, and Seong-HeonWie.Clinical Practice Guidelines for the Antibiotic Treatmentof Community-Acquired Urinary Tract Infections. Infect Chemother 2018;50(1):67-100.
(9) Aboumarzouk OM, Hughes O, Narahari K, Coulthard R,Kynaston H, Chlosta P, Somani B. Emphysematous pyelonephritis:Time for a management plan with an evidence-basedapproach. Arab J Urol 2014;12:106-115.
(10) Diego Martin-Sanchez, Miguel Fontecha-Barriuso, Maria Dolores Sanchez-Niño, Adrian M. Ramos, Ramiro Cabello, Carmen Gonzalez-Enguita, Andreas Linkermann, Ana BelénSanz, and Alberto Ortiz.Cell death-based approaches in treatmentof the urinary tract-associated diseases: afight for survival in the killing fields. Martin-Sanchez et al. Cell Death and Disease, 2018, 9118, 1-14.
(11) Hooton, T. M. 2001. Recurrent urinary tract infection in women. Int. J. Antimicrob.Agents 17: 259-268.
(12) Foxman, B. 1990. Recurring urinary tract infection: incidence and risk factors.Am. J. Public Health 80: 331-333.
(13) Ana L. Flores-Mireles, Jennifer N. Walker, Michael Caparon, and Scott J. Hultgren.
(14) Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May ; 13(5): 269–284.
(15) Helen S. Leeand Jennifer Le. Urinary Tract Infections. PSAP 2018 Book 1,Infectious Diseases, 7-28.
(16) Neha Nanda and ManishaJuthani-Mehta. Novel Biomarkers for the Diagnosis of Urinary TractInfection-a Systematic Review. Biomarker Insights 2009:4 111-121.
(17) Kelsey E. Sivick, Matthew A. Schaller, Sara N. Smith andHarry L. T. Mobley. The Innate Immune Response toUropathogenicEscherichia coli InvolvesIL-17A in a Murine Model of Urinary TractInfection. J Immunol2010; 184:2065-2075.
(18) Benjamin L. Duell, Alison J. Carey, Chee K. Tan, XiangqinCui, Richard I. Webb, MakrinaTotsika, Mark A. Schembri,Petra Derrington, Helen Irving-Rodgers, Andrew J. Brooks,Allan W. Cripps, Michael Crowley and Glen C. Ulett. Innate Transcriptional Networks Activated inBladder in Response to UropathogenicEscherichia coli Drive Diverse BiologicalPathways and Rapid Synthesis of IL-10 forDefense against Bacterial Urinary TractInfection. J Immunol2012; 188:781-792.
(19) FouadMadhiet al, 2018.Febrile urinary-tract infection due toextended-spectrum beta-lactamase-producing Enterobacteriaceae in children: AFrench prospective multicenter study. PLoS One. 2018 Jan 25;13(1):e0190910.
(20) MatthijsOyaert, Britt Van Meensel, ReinoudCartuyvels, Johan Frans, WimLaffut, Patricia Vandecandelaere, Hans De Beenhouwer.Laboratory diagnosis of urinary tract infections: Towards a BILULUconsensus guideline. Journal of Microbiological Methods 146 (2018), 92-99.
(21) Song R and Yosypiv I V 2011. Genetics of congenital anomalies of the kidney and urinary tractPediatr. Nephrol. 26(3),353-64.
(22) Al-Achi, Antoine (2008). An introduction to botanical medicines : history, science, uses, and dangers. Westport, Conn.: Praeger Publishers. p. 126. ISBN 978-0-313-35009-2. Archivedfrom the original on 2016-05-28
(23) Wilson...], [general ed.: Graham (1990). Topley and Wilson's Principles of bacteriology, virology and immunity: in 4 volumes (8. ed.). London: Arnold. p. 198. ISBN 0-7131-4591-9.
(24) Al-Achi, Antoine (2008). An introduction to botanical medicines : history, science, uses, and dangers. Westport, Conn.: Praeger Publishers. p. 126. ISBN 9780313350092.
(25) Wilson...], general ed.: Graham (1990). Topley and Wilson's Principles of bacteriology, virology and immunity: in 4 volumes (8. ed. ed.). London: Arnold. p. 198. ISBN 0713145919.
(26) Nicolle LE (2008). "Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis". Urol Clin North Am 35 (1): 1–12, v. doi:10.1016/j.ucl.2007.09.004. PMID 18061019
(27) Woodford, HJ; George, J (2011 Feb). "Diagnosis and management of urinary infections in older people.". Clinical medicine (London, England) 11 (1): 80-3. PMID 21404794
(28) The short textbook of Medical Microbiology,Satish Gupte, Ninth Edition, Jaypee Brothers, Medical Publishers(p) LTD PP-454
(29) Lippincott's illustrated reviews,Richard A.Harvey,Pamela.C.Champe,Microbiology second Edition,PP374-375.
(30) Sherris Medical Microbiology ,fifth Ed,Kenneth .J.Ryan,C.George Ray,Nafees ahmad,W.Lawrence Drew, James.J.Plorde, Mcgraw Hill-Medical,pp-939-941
(31) Jia Fong Jhang, Hann ChorngKuo.Recent advances in recurrent urinary tract infection from pathogenesis and biomarkers to prevention. Tzu Chi Medical Journal 2017; 29(3): 131-137.
(32) John David Spencer, Andrew L. Schwaderer,Brian Becknell,Joshua Watson,and David S. Hains.The innate immune response during urinary tract infection and Pyelonephritis. PediatrNephrol. 2014 July ; 29(7): 1139-1149.
(33) StammWE,NorrbySR,Urinary tract infections:Disease panorama and changes.J.of.Inf.disease ,2001:183,Suppl,:si,s4 (pubmed)
(34) Chen YH,Ko.WC,Hsueh PR,Emerging resistance problems and future perspectives in pharmacotherapy for complicated urinary tract infections.Expert Opin Pharmacother:2013,14:587-596
(35) Kostakioti M,Hultgren SJ,Hadjifrangiskou,M.Molecular blue print of ureopathogenic Escherichia coli virulence provides clues toward the development of anti virulence therapeutics. Virulence 2012:3:592-594(pubmed)
(36) Levison ME, Kaye D. Treatment of complicated urinary tract infections with an emphasis on drug-resistant gram-negative uropathogens. Curr Infect Dis Rep. 2013;15(2):109-115.
(37) Helen S. Lee and Jennifer Le. Urinary Tract Infections. PSAP 2018 Book 1.Infectious Diseases, 7-28.
(38) Fouad Madhi et al. Febrile urinary-tract infection due to extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: A French prospective multicenter study. PLoS One. 2018 Jan 25;13(1): e0190910.
(39) Hamdan Z Hamdan, Abdel Haliem M Ziad, Salah K Ali, Ishag Adam. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital. Annals of Clinical Microbiology and Antimicrobials 2011, 10:2, 1-5.
(40) Sanchez GV, Babiker A, Master RN, et al. Antibiotic resistance among urinary isolates from female outpatients in the United States in 2003 and 2012. Antimicrob Agents Chemother 2016;5:2680-3.
(41) Levison ME, Kaye D. Treatment of complicated urinary tract infections with an emphasis on drug-resistant gram-negative uropathogens. Curr Infect Dis Rep. 2013;15(2):109-115.