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Urinary tract infection 

Urinary tract infection

Chapter:
Urinary tract infection
Author(s):

Charles Tomson

and Alison Armitage

DOI:
10.1093/med/9780199204854.003.2113_update_001

Update:

Painful bladder syndrome/interstitial cystitis—description of ketamine-induced cystitis.

Treatment of uncomplicated cystitis—updated discussion of duration of antibiotic treatment following recent Cochrane reviews. In general, longer courses (up to 7 days) should be given to elderly women, and for UTIs caused by S. Saprophyticus.

UTIs in renal transplant recipients—description and illustration of encrusted pyelitis caused by infection with Corynebacterium urealyticum.

Reflux nephropathy—discussion of use of prophylactic antibiotics updated following recent meta-analyses showing that these confer no clear benefit.

Updated on 25 May 2011. The previous version of this content can be found here.
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date: 28 June 2017

Urinary tract infection (UTI) is a common condition, accounting for 1 to 3% of all primary care consultations in the United Kingdom. It affects patients of both sexes and all ages. The commonest organism causing uncomplicated community-acquired bacterial UTI is Escherichia coli.

The occurrence and course of a UTI is influenced by the integrity of the host defence and by bacterial virulence factors. Disruption of the highly specialized transitional cell epithelium which lines the urinary tract, incomplete bladder emptying, anatomical abnormalities, and the presence of a foreign body, such as a urinary catheter, can all contribute to disruption of the host defence and increase the likelihood of infection. Sexual intercourse, use of condoms, and use of spermicides all increase the risk, and genetic factors influence the susceptibility of some people, e.g. girls with the P1 blood group are at increased risk of acute pyelonephritis. Bacterial characteristics that determine their ability to cause infection include specific mechanisms to adhere to the uroepithelium (‘pili’ or ‘fimbrias’ in the case of certain ...

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