Urinary tract infections

Authors
Citation
R. Funfstuck, Urinary tract infections, NIEREN HOCH, 30(2), 2001, pp. 76-83
Citations number
53
Categorie Soggetti
Urology & Nephrology
Journal title
NIEREN-UND HOCHDRUCKKRANKHEITEN
ISSN journal
03005224 → ACNP
Volume
30
Issue
2
Year of publication
2001
Pages
76 - 83
Database
ISI
SICI code
0300-5224(200102)30:2<76:UTI>2.0.ZU;2-T
Abstract
From the anatomical point of view infections of the lower urinary tract and the pyelonephritis are different diseases, but these kinds of infections a s well as the asymptomatic bacteriuria are based on an equal pathogenetic b ackground. The urinary tract does not present optimal living conditions for all microorganisms. Urine is a medium of changing osmolality containing di fferent substances (immunoglobulines, Tamm-Horsfall-glykoprotein, polyamine s) with an bactericidal effect. In case of acute disease and of microorgani sms persisting in the urinary tract, the adhesion of bacterial strains to t he cells of the epithelial boundary layer plays an important role for the f ollowing step of internalization in the uroepithelium. During this process, the secretion of different cell mediator proteins (IL-6, IL-8, PDGF, TNF-a lpha) will activate various immunocompetent cell populations. Alterations o f specific host-defence mechanisms, the expression of receptors for adhesio n molecules of uropathogens to the surfaces of epithelial cells as well as anatomical abnormalities of the urinary tract determine the course of a dis ease. A great number of efficient drugs is available for treating an acute infection. It is, however, more problematic to decide on the necessity of t reating cases of asymptomatic bacteriuria as well as to chase adequate drug s for chronic recurrent or relapsing infections.