Estrogens And Urinary-tract Infection Nih Pdf

estrogens and urinary-tract infection nih pdf

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Urinary tract infection UTI is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic.

One in three women will experience a clinically significant urinary tract infection UTI by age twenty-four and almost half will have at least one in their lifetime. Recurrent UTIs rUTIs are defined as having greater than two infections in a 6-month period, or three infections over twelve months, with complete resolution for at least two weeks. These may be due to relapse from incomplete treatment persistence or re-infection new source. It may be difficult to distinguish between the two, where the same organism is cultured.

Recent advances in recurrent urinary tract infection from pathogenesis and biomarkers to prevention

Urinary tract infections UTI are a common problem in postmenopausal women. The incidence is higher in patients with diabetes mellitus DM and very often it can be manifested by asymptomatic bacteriuria ASB only. The prevalence of ASB is usually correlated with the length of DM and long—term complications, rather than metabolic parameters of DM [ 1 — 4 ]. Furthermore, the estrogen deficiency has essential role in the presence of bacteriuria. Estrogen fuels the proliferation of lactobacillus in the epithelium of the vagina, lowers the pH, and prevents vaginal colonization of Enterobacteriaceae , the main pathogens of the urinary tract [ 5 , 6 ].

Novel Strategies in the Prevention and Treatment of Urinary Tract Infections

Urinary tract infections are one of the most common bacterial infections, especially in women and children, frequently treated with antibiotics. The alarming increase in antibiotic resistance is a global threat to future treatment of infections. Therefore, alternative strategies are urgently needed. The innate immune system plays a fundamental role in protecting the urinary tract from infections. Antimicrobial peptides form an important part of the innate immunity. They are produced by epithelial cells and neutrophils and defend the urinary tract against invading bacteria. Since efficient resistance mechanisms have not evolved among bacterial pathogens, much effort has been put into exploring the role of antimicrobial peptides and possibilities to utilize them in clinical practice.

A common health-care problem worldwide, urinary tract infection UTI , represents a disease of significant impact on every country's economy, being the most common cause of hospitalization among elderly people and the most common cause of antibiotic prescription in primary care. Diagnosing and managing upper and lower UTI have always been a challenge to physicians, given its high prevalence, risk of recurrence and improper treatment, and the fact of worldwide increase in antibiotic resistance, necessitating implementation of a proper antibiotic stewardship. Urinary infections are twice more likely to occur in females compared to males and its prevalence increases with increasing age. The following is a comprehensive review paper about UTI in females, discussing the various factors leading to a complicated infection. The various etiologies and microbiologies of UTI are also highlighted. In addition to various usual antibiotic regimens for treating UTI, a significant number of nonantimicrobial treatment modalities are highlighted and described in this manuscript, including the novel use of intravesical antibiotics and vaccines for suppression treatment.

Use of products containing spermicide and sexual intercourse increase the risk of recurrences. No studies have shown that hygiene, direction of wiping, or tightness of clothing increase the risk of recurrence. Management can include self initiated antibiotics for each episode but depends on good communication between patient and physician. Recurrences can be prevented with regular low dose antibiotics. The choice and dose of antibiotic should be decided on the basis of previous infections and local microbiological guidance and availability of antibiotics. Non-antimicrobial prevention strategies are promising but have not yet been shown to be as effective as antimicrobial prophylaxis.

Diagnosis and management of recurrent urinary tract infections in non-pregnant women

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Non-surgical management of recurrent urinary tract infections in women

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RubГ­ T.


Increasing antimicrobial resistance has stimulated interest in non-antibiotic prophylaxis of recurrent urinary tract infections UTIs.

Rainer E.


Recurrent urinary tract infection (UTI) might be one of the most common Bacterial survival in the urinary bladder after antibiotic treatment and UTI. Sexual intercourse and estrogen deficiency in postmenopausal women might Available from:​



Recurrent urinary tract infection UTI might be one of the most common problems in urological clinics.

Marguerite C.


Urinary tract infections UTI are common among the female population.

Elizabeth H.


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