From the Guidelines
Escherichia coli is the most common cause of Urinary Tract Infection (UTI) in women.
Key Points
- The European Association of Urology guidelines state that most cases of uncomplicated cystitis are caused by Escherichia coli 1.
- Risk factors for UTI in women include sexual intercourse, use of spermicide, a new sexual partner, a mother with a history of UTI, and a history of UTI during childhood 1.
- Diagnosis of uncomplicated cystitis can be made with a high probability based on a focused history of lower urinary tract symptoms (dysuria, frequency, and urgency) and the absence of vaginal discharge 1.
- Urine culture is recommended in certain situations, such as suspected acute pyelonephritis, symptoms that do not resolve or recur within 4 weeks after completion of treatment, women who present with atypical symptoms, and/or pregnant women 1.
From the Research
Causes of Urinary Tract Infections (UTIs) in Women
- The most common cause of UTIs in women is bacterial infection, with Escherichia coli (E. coli) being the predominant pathogen 2, 3, 4, 5, 6.
- E. coli is responsible for approximately 80% of acute community-acquired uncomplicated UTIs 3.
- Other common pathogens that can cause UTIs in women include Klebsiella, Enterobacter, Proteus, and Staphylococcus saprophyticus 2, 3, 5.
- Host factors such as urinary stasis, abnormal urinary tract anatomy, diabetes mellitus, debility, and aging can predispose women to UTIs 2, 3, 5.
- Estrogen-related issues and short urethras also increase the risk of UTIs in women 2, 6.
Pathogenesis of UTIs
- Bacteria can cause UTIs by ascending through the urethra into the bladder, and must possess virulence factors to do so 2, 6.
- Adhesion of bacteria to the epithelial cells of urogenital mucosa is an important mechanism in the pathogenesis of UTIs 6.
- The human intestinal tract can act as a reservoir of uropathogenic E. coli (UPEC), which can then infect the female urethra 6.