Recurrent urinary tract infections in women. Virulence of pathogens and host reaction

Der Urologe. Ausg. A
T A Oelschlaeger, R Fünfstück

Abstract

The interactions of host-specific and microbial factors are responsible for recurrent urinary tract infections (rUTI). The anatomical properties of the female urogenital tract favor colonization by uropathogens. Local factors such as glucose concentration of the urine, stability of the lactobacilli population, the influence of estrogens, the activity of Tamm-Horsfall protein or of defensins, and disturbance of the systemic defense mechanisms dictate the course of an infection. The most prominent uropathogen is E. coli. It expresses various virulence factors including adhesions, toxins, iron uptake systems, and a capsule. It is still unclear if there are virulence factors characteristic for E. coli strains causing rUTI. The formation of intracellular reservoirs by invasion of uroepithelial cells by E. coli could be another, as yet little noticed cause for rUTI. Therefore, in cases of rUTI the application of intracellularly active antibiotics should be considered.

References

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Citations

Mar 11, 2008·Der Internist·G Stein, R Fünfstück
Feb 7, 2008·Biology Letters·Gillian N RobbStuart Bearhop

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