Home LiteratureArticle Details
PMID: 21139641 Published · ppublish English Journal Article Review

The epidemiology of urinary tract infection.

Nature reviews. Urology ·Vol. 7 ·No. 12 ·2010-12-00 ·Pages 653-60

Foxman B

Abstract

Urinary tract infections (UTIs) are among the most common bacterial infections acquired in the community and in hospitals. In individuals without anatomical or functional abnormalities, UTIs are generally self limiting, but have a propensity to recur. Uropathogens have specialized characteristics, such as the production of adhesins, siderophores and toxins that enable them to colonize and invade the urinary tract, and are transmitted between individuals both through person-to-person contact and possibly via food or water. Although generally self limiting, treatment of UTIs with antibiotics leads to a more rapid resolution of symptoms and is more likely to clear bacteriuria, but also selects for resistant uropathogens and commensal bacteria and adversely affects the gut and vaginal microbiota. As uropathogens are increasingly becoming resistant to currently available antibiotics, it may be time to explore alternative strategies for managing UTI.

MeSH Terms
Drug Resistance, Bacterial Humans Incidence Prevalence Urinary Tract Infections/complications,drug therapy,epidemiology,microbiology,transmission
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Foxman Betsy
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA. bfoxman@umich.edu
References (63)
63 references, click to expand
  1. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients.
    Arch Intern Med. 2000 Mar 13;160(5):678-82 PMID: 10724054
  2. The epidemiology of acute pyelonephritis in South Korea, 1997-1999.
    Am J Epidemiol. 2004 Nov 15;160(10):985-93 PMID: 15522855
  3. Epidemics of nosocomial urinary tract infection caused by multiply resistant gram-negative bacilli: epidemiology and control.
    J Infect Dis. 1976 Mar;133(3):363-6 PMID: 768384
  4. Risk factors for second urinary tract infection among college women.
    Am J Epidemiol. 2000 Jun 15;151(12):1194-205 PMID: 10905532
  5. The diagnosis of urinary tract infection: a systematic review.
    Dtsch Arztebl Int. 2010 May;107(21):361-7 PMID: 20539810
  6. Natural history of recurrent urinary tract infections in women.
    Rev Infect Dis. 1991 Jan-Feb;13(1):77-84 PMID: 2017637
  7. Infections with extended-spectrum beta-lactamase-producing enterobacteriaceae: changing epidemiology and drug treatment choices.
    Drugs. 2010 Feb 12;70(3):313-33 PMID: 20166768
  8. Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters.
    Infect Control Hosp Epidemiol. 2004 Nov;25(11):974-8 PMID: 15566033
  9. Clinical and bacteriological outcome of different doses and duration of pivmecillinam compared with placebo therapy of uncomplicated lower urinary tract infection in women: the LUTIW project.
    Scand J Prim Health Care. 2007 Mar;25(1):49-57 PMID: 17354160
  10. The rise and fall of Escherichia coli O15 in a London teaching hospital.
    J Med Microbiol. 1990 Sep;33(1):23-7 PMID: 1700126
  11. Genetic variation of the human urinary tract innate immune response and asymptomatic bacteriuria in women.
    PLoS One. 2009 Dec 15;4(12):e8300 PMID: 20016852
  12. Antibiotic resistance in outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA).
    Int J Antimicrob Agents. 2005 Nov;26(5):380-8 PMID: 16243229
  13. Engineering out the risk for infection with urinary catheters.
    Emerg Infect Dis. 2001 Mar-Apr;7(2):342-7 PMID: 11294737
  14. Randomised controlled trial of nitrofurantoin versus placebo in the treatment of uncomplicated urinary tract infection in adult women.
    Br J Gen Pract. 2002 Sep;52(482):729-34 PMID: 12236276
  15. Three-day vs longer duration of antibiotic treatment for cystitis in women: systematic review and meta-analysis.
    Am J Med. 2005 Nov;118(11):1196-207 PMID: 16271900
  16. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America.
    Clin Infect Dis. 2010 Mar 1;50(5):625-63 PMID: 20175247
  17. Clinical and economic consequences of nosocomial catheter-related bacteriuria.
    Am J Infect Control. 2000 Feb;28(1):68-75 PMID: 10679141
  18. The ARESC study: an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections.
    Int J Antimicrob Agents. 2009 Nov;34(5):407-13 PMID: 19505803
  19. Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli.
    Infection. 2008 Feb;36(1):41-5 PMID: 18193386
  20. Urinary tract infection: self-reported incidence and associated costs.
    Ann Epidemiol. 2000 Nov;10(8):509-15 PMID: 11118930
  21. Food reservoir for Escherichia coli causing urinary tract infections.
    Emerg Infect Dis. 2010 Jan;16(1):88-95 PMID: 20031048
  22. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults.
    Clin Infect Dis. 2005 Mar 1;40(5):643-54 PMID: 15714408
  23. Current concepts of molecular defence mechanisms operative during urinary tract infection.
    Eur J Clin Invest. 2008 Oct;38 Suppl 2:29-38 PMID: 18826479
  24. Antibiotic resistance of Escherichia coli from community-acquired urinary tract infections in relation to demographic and clinical data.
    Clin Microbiol Infect. 2005 Mar;11(3):199-203 PMID: 15715717
  25. Persistent extended-spectrum beta-lactamase urinary tract infection.
    Emerg Infect Dis. 2009 Nov;15(11):1862-4 PMID: 19891891
  26. Uropathogenic Escherichia coli are more likely than commensal E. coli to be shared between heterosexual sex partners.
    Am J Epidemiol. 2002 Dec 15;156(12):1133-40 PMID: 12480658
  27. Asymptomatic bacteriuria--important or not?
    N Engl J Med. 2000 Oct 5;343(14):1037-9 PMID: 11018172
  28. A prospective study of risk factors for symptomatic urinary tract infection in young women.
    N Engl J Med. 1996 Aug 15;335(7):468-74 PMID: 8672152
  29. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing.
    PLoS Biol. 2008 Nov 18;6(11):e280 PMID: 19018661
  30. Is it necessary to catheterise the bladder routinely before gynaecological laparoscopic surgery?
    Aust N Z J Obstet Gynaecol. 2005 Oct;45(5):380-3 PMID: 16171472
  31. Toll-like receptor polymorphisms and susceptibility to urinary tract infections in adult women.
    PLoS One. 2009 Jun 22;4(6):e5990 PMID: 19543401
  32. Inherited susceptibility to acute pyelonephritis: a family study of urinary tract infection.
    J Infect Dis. 2007 Apr 15;195(8):1227-34 PMID: 17357062
  33. Long-term outcome of patients with a negative work-up for asymptomatic microhematuria.
    Urology. 2010 Jan;75(1):20-5 PMID: 19913883
  34. High prevalence of ST131 isolates producing CTX-M-15 and CTX-M-14 among extended-spectrum-beta-lactamase-producing Escherichia coli isolates from Canada.
    Antimicrob Agents Chemother. 2010 Mar;54(3):1327-30 PMID: 20047913
  35. Antibiotic resistance in community-acquired urinary tract infections: prevalence and risk factors.
    Med Sci Monit. 2010 May;16(5):CR246-51 PMID: 20424552
  36. Definitions, classification, and clinical presentation of urinary tract infections.
    Med Clin North Am. 1991 Mar;75(2):241-52 PMID: 1996031
  37. Risk factors for extended-spectrum beta-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections.
    Clin Microbiol Infect. 2010 Feb;16(2):147-51 PMID: 19689464
  38. Canadian guidelines for the management of asymptomatic microscopic hematuria in adults.
    Can Urol Assoc J. 2009 Feb;3(1):77-80 PMID: 19293985
  39. Community-acquired extended-spectrum beta-lactamase producers, United States.
    Emerg Infect Dis. 2007 Jul;13(7):1121-3 PMID: 18214201
  40. Antimicrobial resistance of Escherichia coli strains causing community-acquired urinary tract infections among insured and uninsured populations in a large urban center.
    J Chemother. 2006 Jun;18(3):255-60 PMID: 17129835
  41. The impact of prulifloxacin on vaginal lactobacillus microflora: an in vivo study.
    J Chemother. 2009 Dec;21(6):646-50 PMID: 20071288
  42. Little evidence for reversibility of trimethoprim resistance after a drastic reduction in trimethoprim use.
    J Antimicrob Chemother. 2010 Feb;65(2):350-60 PMID: 19900952
  43. Bad bugs and beleaguered bladders: interplay between uropathogenic Escherichia coli and innate host defenses.
    Proc Natl Acad Sci U S A. 2000 Aug 1;97(16):8829-35 PMID: 10922042
  44. Association of the Lewis blood-group phenotype with recurrent urinary tract infections in women.
    N Engl J Med. 1989 Mar 23;320(12):773-7 PMID: 2922027
  45. Scientific and clinical challenges in the management of urinary tract infections.
    Am J Med. 2002 Jul 8;113 Suppl 1A:1S-4S PMID: 12113865
  46. Hidden pathogens uncovered: metagenomic analysis of urinary tract infections.
    Andrologia. 2008 Apr;40(2):66-71 PMID: 18336452
  47. Presentation, pattern, and natural course of severe symptoms, and role of antibiotics and antibiotic resistance among patients presenting with suspected uncomplicated urinary tract infection in primary care: observational study.
    BMJ. 2010 Feb 05;340:b5633 PMID: 20139213
  48. Condom use and first-time urinary tract infection.
    Epidemiology. 1997 Nov;8(6):637-41 PMID: 9345662
  49. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA).
    Clin Infect Dis. 1999 Oct;29(4):745-58 PMID: 10589881
  50. Detection of intracellular bacterial communities in human urinary tract infection.
    PLoS Med. 2007 Dec;4(12):e329 PMID: 18092884
  51. Innate and adaptive immune responses in the urinary tract.
    Eur J Clin Invest. 2008 Oct;38 Suppl 2:21-8 PMID: 18826478
  52. Sexual acquisition of urinary tract infection in a man.
    Nephron. 1986;44(3):217-8 PMID: 3537817
  53. A case of recurrently sexually transmitted urinary tract infection.
    Genitourin Med. 1989 Dec;65(6):397-8 PMID: 2693337
  54. Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration.
    Clin Infect Dis. 1992 Nov;15 Suppl 1:S216-27 PMID: 1477233
  55. Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection?--results of a randomized controlled pilot trial.
    BMC Med. 2010 May 26;8:30 PMID: 20504298
  56. Trends in antimicrobial resistance among urinary tract infection isolates of Escherichia coli from female outpatients in the United States.
    Antimicrob Agents Chemother. 2002 Aug;46(8):2540-5 PMID: 12121930
  57. Prevalence of nosocomial infections in The Netherlands, 2007-2008: results of the first four national studies.
    J Hosp Infect. 2010 Jul;75(3):168-72 PMID: 20381910
  58. Community-onset genitourinary tract infection due to CTX-M-15-Producing Escherichia coli among travelers to the Indian subcontinent in New Zealand.
    Clin Infect Dis. 2008 Sep 1;47(5):689-92 PMID: 18665816
  59. Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs.
    Infect Dis Clin North Am. 2003 Jun;17(2):227-41 PMID: 12848468
  60. The natural history of lower urinary tract symptoms in females: analysis of a health screening project.
    Eur Urol. 2007 Dec;52(6):1744-50 PMID: 17822835
  61. Community-onset urinary tract infections: a population-based assessment.
    Infection. 2007 Jun;35(3):150-3 PMID: 17565455
  62. The relationship between pyuria and infection in patients with indwelling urinary catheters: a prospective study of 761 patients.
    Arch Intern Med. 2000 Mar 13;160(5):673-7 PMID: 10724053
  63. Asymptomatic microscopic or dipstick haematuria in adults: which investigations for which patients? A review of the evidence.
    BJU Int. 2002 Aug;90(3):185-98 PMID: 12133052
Article Info
Journal
Nature reviews. Urology
Abbr.
Nat Rev Urol
ISSN
1759-4820
DOI
10.1038/nrurol.2010.190
Email
bfoxman@umich.edu
Published
2010-12-00
Pages
653-60
Language
English
Region
England
NLM ID
101500082
Subset
IM
External Links
PubMed source DOI: 10.1038/nrurol.2010.190 View journal details
Analysis Services
Analysis Services

Contact

No. 2 Wenbo Road, Zhangqiu District, Jinan, Shandong

Qilu Normal University · Genelibs Bioinformatics Lab

750 Shunhua Rd, Jinan

2F, Bldg F, University Science Park

Tel: 0531-88819269

WeChat Official Account

Follow our WeChat subscription account for real-time updates and the latest in medical and biological research.


Business Email

E-mail: product@genelibs.com

Copyright © 2026.Genelibs Jinan Honghui Biotechnology Co., Ltd. 鲁ICP备20007159号-2