73 - Urinary Tract Infections Caused by Bacterial Species other than E. coli

Abstract

The urinary tract is a common site of bacterial infection. Individuals at high risk for symptomatic urinary tract infection (UTI) include neonates, pre-school girls, sexually active women, and the elderly. In addition, UTI is the most frequent cause of infections among nursing home residents and the most common documented source of bacteraemia in the elderly. Escherichia coli (E. coli) is the most common cause of community-acquired infection in the individuals with a normal urinary tract. Nevertheless, other important microorganisms for which much less information is available also cause UTI. This chapter focuses on these less commonly isolated but important organisms. While E. coli is the cause of most infections in the normal urinary tract, many other bacterial species, including other genera of the Enterobacteriaceae as well as Gram-positive organisms, are able to colonize both the normal and the structurally compromised urinary tract. Of these organisms, most is known about P. mirabilis, although other species share common themes of pathogenicity, including adherence, production of urease, and a limited ability to invade host epithelium.