The epidemiology of urinary tract infection

Abstract

Urinary tract infections (UTIs) are among the most common bacterial infections acquired in the community and in hospitals. In individuals without anatomical or functional abnormalities, UTIs are generally self limiting, but have a propensity to recur. Uropathogens have specialized characteristics, such as the production of adhesins, siderophores and toxins that enable them to colonize and invade the urinary tract, and are transmitted between individuals both through person-to-person contact and possibly via food or water. Although generally self limiting, treatment of UTIs with antibiotics leads to a more rapid resolution of symptoms and is more likely to clear bacteriuria, but also selects for resistant uropathogens and commensal bacteria and adversely affects the gut and vaginal microbiota. As uropathogens are increasingly becoming resistant to currently available antibiotics, it may be time to explore alternative strategies for managing UTI.

Recurrent urinary tract infection due to co‐infection with extended spectrum β‐lactamase‐producer uropathogenic Escherichia coli and enteroaggregative E. coli

“…O2, O4, O6 and O75 are the most common serogroups causing UTIs worldwide (George & Manges, 2010). Outbreaks due to particular UPEC strains have been reported from different parts of the world (George & Manges, 2010), indicating that these strains are capable of causing infections in the elderly and the immunosuppressed, including people with diabetes, HIV and chronic heart disease (Foxman, 2010). UPECs have distinct virulence factors, including adhesins, toxins, cytolysins, siderophores and surface components, that enable them to colonize and invade the urinary tract (Foxman, 2010).…”

“…It is estimated that ,150 million cases of UTI occur worldwide, as many as 50 % of women and 12 % of men experience at least one symptomatic UTI during their lives and ,25 % of affected women have recurrent UTI (RUTI) (Foxman, 2010). Non-pathogenic E. coli are widely distributed in nature and an important part of the normal flora in the human gastrointestinal tract.…”

Changing the antibiotic prescribing behaviour of clinicians in primary care

“…The observed absence of differences in baseline prescribing data among the three arms suggests that randomization was effective, and the study population appeared representative of patients presenting to general practices with urinary tract infection (mean age 51-56 yr; 88%-92% women). 7 The sample size was based on a 10% increase in first-line antimicrobial prescriptions in the intervention arms, which was consistent with reported effects. 8 The increases in first-line antibiotic prescriptions of 23% and 17% in intervention arms A and B, respectively -with a secondary analysis that used prescribing of nitro furantoin as the outcome showing an even larger effectindicated that the intervention was successful.…”

Infeções do Trato Urinário da Comunidade da Ilha do Faial, Determinadas no Hospital da Horta EPER - 2016

“…1), facto que pode estar associado ao maior número de mulheres com idade reprodutível nesta faixa etária 12,13 ; de corresponder à faixa etária com há maior taxa de fecundidade 12 e idade média com que as mães tem o primeiro filho. 2 Acresce também que as ITU's apresentam um risco durante a gravidez para a mãe e feto 9 (Fig. 2).…”

“…Situação que promove custos mais elevados para a sociedade e para o sistema de saúde. 1,2 O trato urinário humano é considerado estéril até à parte terminal da uretra, onde existe alguma microflora. Assim, considera-se infeção urinária a presença de bactérias (principais agentes patogénicos da ITU) em qualquer parte do sistema urinário (com a exceção da uretra), capazes também de se multiplicarem e induzirem processos inflamatórios nas variadas partes do sistema urinário.…”