HOST-DEFENSE MECHANISM IN THE PATHOGENESIS OF UTI AND UTI IN IMMUNOCOMPROMISED PATIENTS

Defects in the immune system determine the clinical manifestations and severity of urinary tract infections (UTI) and the rates of complicat ion but they only have an indirect role in influencing susceptibility to infection. The rates of UTI in diabetics, renal transplant recipien ts, neutropenic patients, and patients with AIDS are primarily determi ned by the degree and duration of urinary tract manipulation and the h igher perineal prevalence of potential pathogens that result from freq uent hospitalization and antimicrobial use. Prompt recognition and tre atment of established infections is critical to prevent life-threateni ng complications (e.g. bacteremia, emphysematous pyelonephritis) but r outine screening for asymptomatic bacteriuria is indicated only in kid ney recipients less that 3 months post-transplantation.