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Urinary Tract Tex2 - Urinary Tract Text 1 Epidemiology UTI...

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Urinary Tract Text 1. Epidemiology UTI are far more common in women than in men, probably because of the shorter urethra in the female. Prostatic secretions in the male may have some antibacterial effect. 2. Pathogenesis Nearly all UTI arise by the "ascending route." Fecal organisms, principally Escherichia coli, colonize the vaginal introitus. Their entry into the bladder is facilitated by sexual intercourse, contraceptive diaphragms, and spermicides. The contraceptive pill has no effect on the incidence of UTI. Some women are prone to have multiple urinary reinfections. These women may be colonized by strains of E. coli with "stickier" fimbriae (anchoring them to the epithelial cells) or may have "stickier" epithelial cells (a phenomenon related to certain blood groups). In addition, the factors noted earlier may contribute to multiple reinfections. In elderly women, vaginal atrophy leads to a reduction in the counts of lactobacilli in the vagina: thus, the vaginal secretions become less acidic and gram-negative enterics more easily colonize. The most potent risk factors for UTI in
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