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PubMed2026

Heightened frequency of innate immunity risk alleles in south Indian diabetics with urinary tract infections.

Urinary Tract Infections are an emerging public health concern among individuals with diabetes mellitus, particularly in South Asia where high disease burden, genetic diversity and increasing drug resistance contribute to the progressive increase in burden. While metabolic and clinical risk factors are well studied, the role of host innate immune genetic variations in shaping UTI susceptibility among diabetics remains poorly understood. This case-control study evaluated functional polymorphisms in key innate immunity genes, TLR4 (rs4986790, rs4986791), MBL2 (rs1800450) and LTA (rs909253), in 70 T2D patients with UTI and 70 T2D patients without UTI. Genotyping was performed using 5'-hydrolysis probe assay. Across all the four SNPs, the risk allele consistently showed a higher frequency among T2D patients with UTI, indicating a directional trend suggestive of cumulative susceptibility. Also, a strong and significant protective association was observed for the LTA rs909253 'G' allele, which was less frequent in cases than controls. This low-inflammatory 'AA' genotype was also markedly enriched among rUTI cases compared to controls. Clinically, 34.3% of cases experienced rUTIs. This observed directional increase of risk alleles across all four innate immunity SNPs, along with the protective role of LTA rs909253 'G' allele, highlights cumulative host genetic modulation of UTI risk in T2D and supports translational use of genetic profiling in infection risk prediction.

Humans↗
PubMedDate not supplied

Management of urinary tract infections.

Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.

Acute Disease↗
PubMed1999

[Enzymuria and urinary tract infection].

Urinary tract infection (UTI) can lead to kidney damage. The analysis of urinary enzyme activities is a sensitive, non-invasive method to recognise renal tubular lesions. The most important enzymes for kidney diagnosis, pathomechanism of urinary enzyme activity changes in the course of UTI and other factors influencing enzyme excretion are described. Interpretation of enzymuria, its clinical significance for kidney damage diagnosis and prognosis of disease are presented.

Enzymes↗
PubMed1990

Rational approaches to the treatment of first time, relapsing, and recurrent urinary tract infections.

Urinary tract infections (UTIs) in the dog are common clinical problems that often respond to a variety of therapeutic regimes. There are, however, many cases of non-responding or recurring infections that require a more systematic approach to therapy. This involves a simple process defining duration, clinical severity, and location, as well as clear identification of the UTI as relapsing or recurrent. Based on these factors, therapeutic approaches and clinical expectations can be developed, improving the chances of resolution in these often frustrating cases.

Animals↗
PubMed1991

[Treatment of urinary tract infections].

Urinary tract infection (UTI) is common in pediatric age groups and may cause permanent renal damage. Because UTI may occur as the first manifestation of urinary tract malformation, evaluation, of urinary tract morphology should be routine. Variables influencing selection of the most appropriate therapy include the causative organism, location of the infection to the distal and/or proximal urinary tract, severity of constitutional symptoms, age, and history for prior urologic disease. Treatment of pyelonephritis requires bactericidal antimicrobial agents capable of achieving rapid sterilization of the renal parenchyma. Animal experiments have shown that the most effective agents are third-generation cephalosporins and aminoglycosides. Antibiotics are selected on the basis of age and severity of infectious symptoms. In infants under 18 months of age and in patients with severe constitutional symptoms, parenteral administration of both a third-generation cephalosporin and an aminoglycoside is recommended. Patients above 18 months of age who are not severely ill can be given a single oral drug, e.g., a cephalosporin, amoxicillin with clavulanic acid, or cotrimoxazole. Therapy should be continued for ten days in patients with infection of the proximal urinary tract, whereas 5 to 7 days are adequate in patients with cystitis and normal urinary tract morphology.

Anti-Bacterial Agents↗
PubMed1990

Urinary tract infections.

Urinary tract infections are a common infection for the primary care physician to see in the office. Epidemiology, pathogenesis, diagnosis, management, and prophylaxis are discussed. Information regarding special patient populations, such as pregnant women and children, is also provided.

Humans↗
PubMed2005

Tamm-Horsfall protein: a multilayered defence molecule against urinary tract infection.

Urinary tract infection (UTI) is the most common nonepidemic bacterial infection in humans, representing a constant danger for the host. Both innate and adaptive components of the immune system as well as stromal cells including bladder epithelium are involved in the prevention and clearance of UTI. However, the particular properties of the urogenital tract, which does not comprise typical physical barriers like a mucus or ciliated epithelium, necessitate soluble mediators with potent immunomodulatory capabilities. One candidate molecule capable of both mediating direct antimicrobial activity and alerting immune cells is the evolutionary conserved Tamm-Horsfall protein (THP). Tamm-Horsfall protein is exclusively produced by the kidney in the distal loop of Henle; however, its definite physiological function remains elusive. Mounting evidence indicates that beyond a mere direct antimicrobial activity, THP exerts potent immunoregulatory activity. Furthermore, the genetic ablation of the THP gene leads to severe infection and lethal pyelonephritis in an experimental model of UTI. Recent data are provided demonstrating that THP links the innate immune response with specific THP-directed cell-mediated immunity. In light of these novel findings we discuss the particular role of THP as a specialized defence molecule. We propose an integrated model of protective mechanisms against UTI where THP acts by two principle nonmutually exclusive mechanisms involving the capture of potentially dangerous microbes and the ability of this peculiar glycoprotein to induce robust protective immune responses against uropathogenic bacteria.

Anti-Infective Agents↗
PubMed1997

Bacterial virulence in urinary tract infection.

Urinary tract infections (UTI) are caused by a variety of gram-negative bacteria that ascend into the urinary tract and establish bacteriuria often at levels greater than or equal to 10(5) bacteria/ mL of urine. Escherichia coli dominate as the causative agent in all patient groups, with Staphylococcus saprophyticus as the second most common, accounting for about 10% to 30% of the infections in young adult women depending on the season. This article covers the pathogenesis and inflammatory response of UTI and the virulence factors of uropathogenic E. coli.

Adult↗
PubMed1992

[Diagnosis and therapy of urinary tract infections].

Urinary tract infections (UTI) are one of the most frequent indications for antibacterial chemotherapy. We must be differentiate between complicated and uncomplicated as well as between upper and lower UTI. Regarding the definition of significant bacteriuria (> or = 10(5) CFU/ml), some relativations are necessary. Dip-slide techniques proved to be very useful for bacteriological diagnosis. The calculated therapy depends upon age and sex and is different for community-acquired and nosocomial infections. Further items are the selection of antibacterial agents, the duration of chemotherapy, the role of asymptomatic bacteriuria and reinfection prophylaxis.

Anti-Bacterial Agents↗
PubMed1992

Urinary tract infection.

Urinary tract infections are the most common bacterial infections experienced by elderly patients. These infections are often asymptomatic, although on occasion they produce discomfort for selective older patients (particularly those with obstructive uropathy), and present a risk for bacteremia, septic shock, adult respiratory distress syndrome, and death. The limited available data suggest that there are major differences with regard to pathogenesis, microbiology, clinical features, laboratory abnormalities, and therapy between young and elderly women who develop symptomatic pyelonephritis. There is a need to provide a standard antibiotic prophylaxis program to those elderly patients with specific cardiac conditions who are scheduled to undergo urinary procedures.

Age Factors↗
PubMedDate not supplied

The resistance of Escherichia coli strains isolated from community-acquired urinary tract infections.

Urinary tract infections (UTIs) are the most common infections caused by Escherichia coli. Most recent research demonstrates that antibiotic resistance has reached a critical point throughout the world, as increased use of antibiotics among nonhospitalized patients encourages the growth of drug-resistant pathogens among that population. The goal of this study was to determine the antimicrobial drug resistance of E coli strains isolated from community-acquired UTIs in 5 different regions in Turkey. The minimum inhibitory concentrations of ciprofloxacin, gentamicin, sulfamethoxazole, trimethoprim, trimethoprim-sulfamethoxazole, and ampicillin and for E coli were determined with the agar dilution method. Among the 480 strains isolated, 8.3% were resistant to ciprofloxacin, 3.3% to gentamicin, 35.4% to sulfamethoxazole, 33.3% to trimethoprim, 27.9% to trimethoprim-sulfamethoxazole, and 40.8% to ampicillin. These results show that the antibiotics currently most effective against E coli are ciprofloxacin and gentamicin. Local epidemiologic trends should be considered when prescribing antibacterial therapy. More research in bacterial gene mapping will be necessary to elucidate the influence of regional antimicrobial drug use and resistance in epidemiologic trends among the general population.

Anti-Bacterial Agents↗
PubMed2001

Pediatric urinary tract infections.

Urinary tract infection in the pediatric population can lead to significant morbidity if not treated promptly and appropriately. All first infections may signify possible underlying anatomic or functional abnormality and require imaging of the lower and upper tracts. Accurate diagnosis of UTIs requires a properly collected quantitative urine culture. Treatment should be tailored to the pathogen as dictated by the urine culture sensitivities to minimize the development of multidrug-resistant organisms. Prophylactic agents should differ from the antibiotic used in the acute setting and preferably concentrated in the urinary tract, with minimal effects on the normal fecal flora. In the long term, patients with documented evidence of renal scarring should be followed up for signs of renal deterioration and hypertension.

Child↗
PubMed1982

Activities of amoxicillin and clavulanic acid combinations against urinary tract infections.

Urinary tract infection caused by beta-lactamase-producing bacteria were treated with 500 mg of amoxicillin three times daily plus either 250 or 125 mg of clavulanic acid three times daily. The overall cure rate was 63.6%, 77.7% with the high dose of clavulanic acid and 53.8% with the low dose. Gastrointestinal intolerance was common in the high-dose clavulanic acid regimen.

Administration, Oral↗
PubMed1986

Antibiotic use as an inducer of resistant urinary tract infections.

Urinary tract infection is second in frequency only to respiratory infection as an indication for antimicrobial chemotherapy. As a result, a significant proportion of both domiciliary and hospital patient populations are exposed to chemotherapy which, in turn, may act as a potent selection pressure for development of resistance mediated by intrinsic mechanisms or acquisition of R-plasmids or transposons. The widespread use of broad spectrum agents has encouraged the development of such resistance in enterobacteria, notably but not exclusively amongst the Klebsiella-Enterobacter-Serratia group, leading to the creation of patient reservoirs of multiply-antibiotic-resistant bacteria. Such situations occur frequently in urological units, amongst catheterised individuals receiving chemotherapy, and, via cross-infection, may rapidly spread to other units and other hospitals. The use of antibiotic combinations, such as co-trimoxazole, may not prevent such problems, which are however amenable to policies which restrict, either selectively or globally, antibiotic use. Such policies can be expected to control the spread of multiply-antibiotic-resistant infection.

Anti-Bacterial Agents↗
PubMed2003

Neutrophil bactericidal function is defective in patients with recurrent urinary tract infections.

Urinary tract infection (UTI), most frequently caused by Escherichia coli, is one of the most common bacterial infections in humans. It is a host inflammatory response to bacterial invasion in which large numbers of neutrophils are recruited into the bladder in response to cytokines secreted by the infected bladder epithelium. We hypothesise that an impaired host neutrophil response leads to susceptibility to recurrent UTI (rUTI). Therefore, the neutrophil inflammatory response of patients with a history of rUTI was compared to healthy controls. No difference in neutrophil adhesion receptor expression or complement receptor expression following bacterial stimulus was detected between the two groups. However, the expression of the IgG receptor CD16, bacterial phagocytosis and reactive oxygen intermediate (ROI) production were significantly reduced in UTI patient neutrophils compared to controls. Neutrophils from rUTI patients have a significantly reduced bactericidal function when compared to healthy controls, with the former showing a reduced capacity for activation. This reduced neutrophil function may result in defective bacterial clearance and lead to susceptibility to recurrent infection.

Adult↗
PubMed2000

Urinary tract infections.

Urinary tract infections are some of the most commonly treated bacterial infections in adults. Factors contributing to development of UTIs include personal habits, sexual habits, altered immune status, presence of diabetes, lack of estrogen and use of spermacides. Untreated or persistant UTIs may cause other more serious complications such as kidney damage or prostate infections. Symptoms that persist after appropriate treatment need further evaluation. As with any disease, appropriate patient education is necessary to help the client understand the process and follow an effective treatment plan.

Behavior Therapy↗
PubMed2004

Current concepts in urinary tract infections.

Urinary tract infections (UTIs) are common infectious diseases that can be associated with substantial morbidity and significant expenditures. This review highlights the current concepts and recent advances in our understanding and management of this condition. Specific topics include pathogenesis, host factors, antimicrobial resistance, recurrent UTIs in women, diagnosis, treatment of uncomplicated and complicated UTIs, prophylaxis, catheter associated bacteriuria, pregnancy, diabetes, UTIs in men, prostatitis, and the chronic pelvic pain syndrome. UTIs can be viewed as an interaction between specific bacterial virulence factors and the patient. A new model explaining the pathogenesis of recurrent UTIs has been presented. There is a need to reconsider traditional treatment recommendations in the face of local resistance patterns, as well as the need to make better use of drugs that are currently available. Prospects for prevention of recurrent UTI include natural compounds, bacterial interference and immunization. With regard to UTI risk in women, patients can be classified based on age, and functional and hormonal status. Appropriate treatment approaches must be based on this classification. In contrast to uncomplicated UTIs, management of most complicated infections depends on clinical experience and resources at individual institutions rather than on evidence based guidelines. Asymptomatic bacteriuria generally should not be treated except in high-risk catheterized patients and in pregnancy. UTIs in men generally require formal urologic evaluation. Our understanding of the etiologies, diagnostic strategies, and treatment options for prostatitis and the chronic pelvic pain syndrome in men continues to evolve.

Abscess↗
PubMed1978

Guidelines for diagnosing and treating urinary tract infections.

Urinary tract infections are problems in both men and women in the geriatric age group, although causative factors in each sex differ widely. Diagnostic evaluation is directed at determining obstructive disease in men and underlying anatomic abnormalities in both men and women. Bacteriologic diagnosis is important, and localization studies are often helpful. Antibiotic therapy is guided by the usual standards, with special awareness of the greater incidence of chronic or degenerative disease in older patients.

Anti-Bacterial Agents↗