UTI 1

Question 1

What is the epidemiology of UTIs?

Answer 1

• Urinary tract infections are common events, particularly in young boys, prepubertal children and women.
• These infections require more than 7 million office visits per year in the U.S. and expenses exceed $1billion annually.

Question 2

Describe the pathogenesis of UTIs.

Answer 2

• The bacteria present virulence factors which allow them to ascend from the gut to the urethra and into the bladder.
  
  • One of the key virulence factors is the ability of the bacteria to bind to the cell surface using type 1 pili.
  • If bacteria also possess p-pili, they can adhere to the upper tract and cause a kidney infection.
• Bacterial colonization of the vaginal mucosa of women with susceptibility to urinary tract infections is much greater than healthy controls, precedes urinary tract infections, and is a critical link in this pathway.
• Women with increased susceptibility to UTIs have a systemic genetically controlled alteration in their cell’s ability to bind pathogenic bacteria.
  
  • Once the adhesive process begins, the host tries to defend itself and the bacteria try to impede the defense by altering the inflammatory, apoptotic, and invasive pathways.
• A number of factors contribute to increased susceptibility of urinary tract infection. Host factors include those that promote colonization, facilitate ascent and reduce urine flow.

Question 3

What are the symptoms of a UTI?

Answer 3

• Symptoms for cystitis include dysuria, urgency and frequency
• Pyelonephritis has the same symptoms as cystitis plus fever, chills and flank pain