47 Pathophysiology of Bacterial Cystitis SpringerLink

Pathophysiology of Bacterial Cystitis
Advances in Bladder Research pp 325-338 | Cite as
James A. Roberts (1) (2)
1. Tulane Regional Primate Research Center, , Covington, USA

2. Tulane University School of Medicine, , New Orleans, USA
Chapter
6 Citations
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Part of the Advances in Experimental Medicine and Biology book series (AEMB,
volume 462)
Abstract
Most bacterial urinary tract infections (UTI) occur by the ascending route and are
due to bacteria that normally colonize the patient’s gastrointestinal tract. While 80
to 90% of UTI are due to Escherichia coli 1, in young women a gram positive
organism, Staphylococcus saprophyticus may cause up to 20% of the cases of acute
cystitis.2 Hospital-acquired infections associated with catheters or instrumentation,
however, are more frequently due to bacterial species such as Enterobacter,
Klebsiella, Proteus, or Pseudomonas. Colonization of both squamous and urothelial
cells due to bacterial adhesion is necessary to initiate an ascending infection. After
colonization of the perineum for various periods of time, colonization of the urethra,
then bladder occurs by means of bacterial adherence. In this review I will
concentrate on the pathogenesisof E. coli cystitis. Adherence by E. coli is due to P, X
or type 1 fimbriae as well as non-fimbrial adhesins.3,4 Cystitis may ensue once
colonization of the bladder occurs and the bacteria remain for a time sufficient
enough to reach a critical concentration necessary to cause disease. Twenty percent
of females will have a urinary tract infection at some time during their lives, while
twenty per cent of those who develop one infection will have a recurrence. Women
may be susceptible due to genetic factors since it has been shown that those who do
not have blood group antigens in their secretions (which may interfere with bacterial
adhesion) more frequently have urinary tract infections.5
Keywords
Urinary Tract Infection Cynomolgus Monkey Bacterial Adhesion
Urothelial Cell Asymptomatic Bacteriuria
These keywords were added by machine and not by the authors. This process is
experimental and the keywords may be updated as the learning algorithm improves.
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Roberts J.A. (1996) Pathophysiology of Bacterial Cystitis. In: Baskin L.S., Hayward S.W. (eds) Advances
in Bladder Research. Advances in Experimental Medicine and Biology, vol 462. Springer, Boston, MA
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