Abstract
The management of infections of the urinary tract provides a continuing challenge to the physician for a variety of reasons. They are common-an estimated 10–20% of women will experience one. They may be painfully symptomatic or entirely silent. They tend to recur, in some with near incapacitating frequency. Approaches to therapy have been shifting, with emphasis on shorter duration of treatment on one end of the spectrum and longer on the other. Finally, perspective on their long- term risks is being clarified, with reassurance for most, but with definition of populations in whom their consequences may be critical.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Fairley KF: The routine determination of the site of infection in the investigation of patients with urinary tract infection. In: Kincaid-Smith P, Fairley KF (eds) Renal Infection and Renal Scarring. Mercedes, Melboume, 1970, pp 107–116.
Thomas VL, Forland M: The significance of antibody- coated bacteria in urinary tract infections. Kidney Int 21: 1–7, 1982.
Carvajal HF, Pasey RB, Berger M, et al: Urinary lactic dehydrogenase isoenzyme 5 in the differential diagnosis of kidney and bladder infection. Kidney Int 8: 176–184, 1976.
Schwartz H, Schirmer HKA, Post B, et al: Correlation of Escherichia coli occurring simultaneously in the urine and stool of patients with clinically significant bacteriuria: Serotyping with group-specific O antisera. J Urol 101:379– 382, 1969.
Glynn AA, Bmmfitt W, Howard CJ: K antigens of Escherichia coli and renal involvement in urinary tract infections. Lancet 1: 514–516, 1971.
Ofek I, Beachey EH: Bacterial adherence. Adv Intem Med 25: 503–532, 1980.
Musher DM, Griffith DP, Yawn D, et al: Role of urease in pyelonephritis resulting from urinary tract infection with Proteus. J Infect Dis 131: 177–181, 1975.
Guze LB, Kalmanson GM: Persistence of bacteria in ‘protoplast’ form after apparent cure of pyelonephritis in rats. Science 143: 1340–1341, 1964.
Stamey TA, Sexton CC: The role of vaginal colonization with enterobacteriaceae in recurrent urinary infections. J Urol 113: 214–217, 1975.
Cattell WR, McSherry MA, Northeast A, et al: Periurethral enterobacterial carriage in pathogenesis of recurrent urinary infection. Br Med J 4: 136–139, 1974.
Stamey TA, Timothy MM: Studies of introital colonization in women with recurrent urinary tract infections. I. Tole of vaginal pH. J Urol 114: 261–263, 1975.
Fowler JE Jr, Stamey TA: Studies of introital colonization in women with recurrent urinary infections. VII. The role of bacterial adherence. J Urol 117: 472–476, 1977.
Schaeffer AJ, Jones JM, Dunn JK: Association of in vitro Eschericia coli adherence to vaginal and buccal epithelial cells with susceptibility of women to recurrent urinary tract infections. N Engl J Med 304: 1062–1066, 1981.
Stamey TA, Wehner N, Mihara G, et al: The immunologic basis of recurrent bacteriuria: Role of cervicovaginal antibody in enterobacterial colonization of the introital mucosa. Medicine 57: 47–56, 1978.
Kurdydyk LM, Kelly K, Harding GKM, et al: Role of cervicovaginal antibody in the pathogenesis of recurrent urinary tract infection in women. Infect Immunol 29:76– 82, 1980.
Bran JL, Levison ME, Kaye D: Entrance of bacteria into the female urinary bladder. N Engl J Med 286: 626–629, 1972.
Buckley RM Jr, McGuckin M, MacGregor RR: Urine bacterial counts after sexual intercourse. N Engl J Med 298: 321–324, 1978.
Cox CE, Hinman F: Experiments with induced bacteriuria, vesical emptying and bacterial growth on the mechanism of bladder defense to infection. J Urol 86: 739–748, 1961.
Vivaldi E, Cotran R, Zangwill DP, et al: Ascending infection as a mechanism in pathogenesis of experimental nonobstructive pyelonephritis. Proc Soc Exp Biol Med 102: 242–244, 1959.
Chemew I, Braude AI: Depression of phagocytosis by solutes in concentrations found in the kidney and urine. J Clin Invest 41: 1945–1953, 1962.
Beeson PB, Rowley D: The anti-complementary effect of kidney tissue. J Exp Med 110: 685–697, 1959.
Fair WR, Wehner N: The prostatic antibacterial factor: identity and significance, in: Marberger H, Haschek H, Schirmer HKA, et al (eds) Prostatic Disease. Alan R Liss, New York, 1976, pp 383–403.
Kass EH: Asymptomatic infections of the urinary tract. Trans Assoc Am Phys 69: 56–63, 1956.
Kass EH: Bacteriuria and the diagnosis of infections of the urinary tract; with observations on the use of methionine as a urinary antiseptic. Arch Intern Med 100: 709–714, 1957.
Simon HB, Weinstein AJ, Pasternak MS, et al: Genitourinary tuberculosis: Clinical features in a general hospital population. Am J Med 63: 410–420, 1977.
Stamm WE, Wagner KF, Amsel R, et al: Causes of the acute urethral syndrome in women. N Engl J Med 303: 409–415, 1980.
Lindner LE, Jones RN, Haber MH: A specific urinary cast in acute pyelonephritis. Am J Clin Pathol 73:809– 811, 1980.
Kunin CM: The quantitative significance of bacteria visualized in the unstained urinary sediment. N Engl J Med 265: 589, 1961.
Cohen S, Kass EH: A simple method for quantitative urine culture. N Engl J Med 277: 176–180, 1967.
Dodge WF, West EF, Fras PA, et al: Detection of bacteriuria in children. J Ped 74: 107–110, 1969.
Bennett WM, Muther RS, Parker RA, et al: Drug therapy in renal failure: dosing guidelines for adults. Part 1. Antimicrobial agents, analgesics. Ann Intern Med 93: 62–89, 1980.
Levison SP, Kaye D: Response of enterococcal pyelonephritis to furosemide-induced diuresis alone and in combination with ampicillin. J Infect Dis 127: 626–631, 1973.
Freedman LR: Experimental pyelonephritis. XIII. On the ability of water diuresis to induce susceptibility to E. coli bacteriuria in the normal rat. Yale J Biol Med 39:255– 266, 1967.
Ronald AR, Cutler RE, Turck M: Effect of bacteriuria on renal concentrating mechanisms. Ann Intern Med 70: 723–733, 1969.
Clark H, Ronald AR, Cutler RE, et al: The correlation between the site of infection and maximal concentrating ability in bacteriuria. J Infect Dis 120: 47–53, 1969.
Lathem W: Hyperchloremic acidosis in chronic pyelonephritis. N Engl J Med 258: 1031–1036, 1958.
Schambelan M, Sebastian A, Hulter HN: Mineralocorticoid excess and deficiency syndromes. Contemporary Issues in Nephrology 2: 232–268, 1978.
Fair WR, McClennan BL, Jost RG: Are excretory urograms necessary in evaluating women with urinary tract infection? J Urol 121: 313–315, 1979.
Fowler JE Jr, Pulaski ET: Excretoty urography, cystography, and cystoscopy in the evaluation of women with urinary-tract infection: a prospective study. N Engl J Med 304: 462–465, 1981.
Thorley JD, Jones SR, Sanford JP: Perinephric abscess. Medicine 53: 441–451, 1974.
Cardiff-Oxford Bacteriuria Study Group: The sequelae of covert bacteriuria in schoolgirls. Lancet 1: 889–893, 1978.
Sabath LD, Gerstein DA, Loder PB, et al: Excretion of erythromycin and its enhanced activity in urine against gram-negative bacilli with alkalinization. J Lab Clin Med 72: 916–923, 1968.
Brumfitt W, Percival A: Adjustment of urine pH in the chemotherapy of urinary tract infection. Lancet 1:186– 190, 1962.
Komaroff AL, Pass TM, McCue JD, et al: Management strategies for urinary and vaginal infections. Arch Intern Med 138: 1069–1073, 1978.
Fang LST, Tolkoff-Rubin NE, Rubin RH: Efficacy of single-dose and conventional amoxicillin therapy in urinary- tract infection localized by the antibody-coated bacteria technic. N Engl J Med 298: 413–416, 1978.
Rubin RH, Fang LST, Jones SR, et al: Single dose amoxicillin therapy for urinary tract infection: multicenter trial using antibody-coated bacteria localization technique. JAMA 244: 561–564, 1980.
Bailey RR, Abbott GD: Treatment of urinary tract infection with a single dose of trimethoprim-sulfamethoxazole. Can Med Assoc J 118: 551–552, 1978.
Ludwig P, Buckwold F, Harding G, et al: Single-dose therapy of acute cystitis in adult females: Prospective randomized comparison of four regimes. In: Neison JD, Grassi C (eds) Current Chemotherapy and Infectious Disease. Proceedings of the 11th International Congress on Chemotherapy, 19th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, D.C., American Society of Microbiology, 1980, pp 1297–1298.
Ronald AR, Boutros P, Mourtada H: Bacteriuria localization and response to single-dose therapy in women. JAMA 235: 1854–1856, 1976.
Stamm WE: Single-dose treatment of cystitis. JAMA 244: 591–592, 1980.
Turck M, Ronald AR, Petersdorf RG: Relapse and reinfection in chronic bacteriuria. II. The correlation between site of infection and pattern of recurrence in chronic bacteriuria. N Engl J Med 278: 422–427, 1968.
Cattell WR, Charlton CAC, McSherry A, et al: The localization of urinary tract infection and its relationship to 73. relapse, reinfection and treatment. In: Brumfitt W, Asscher AW (eds) Urinary Tract Infection. Oxford University Press, London, 1973, pp 206–214.
McGeachie J: Recurrent infection of the urinary tract: reinfection or recrudescence? Br Med J 1: 952–954, 75. 1966.
Turck M, Browder AA, Lindemeyer RJ, et al: Failure of prolonged treatment of chronic urinary tract infections with antibiotics. N Engl J Med 267: 999–1005, 1962.
Kincaid-Smith P, Fairiey KF: Controlled trial comparing effect of two and six weeks’ treatment in recurrent urinary tract infection. Br Med J 2: 145–146, 1969.
Harding GKM, Ronald AR: A controlled study of antimicrobial prophylaxis of recurrent urinary infection in women. N Engl J Med 291: 597–601, 1974.
Stamey TA, Condy M, Mihara G: Prophylactic efficacy of nitrofurantoin macrocrystals and trimethoprim-sulfamethoxazole in urinary infection. N Engl J Med 296: 780–783, 1977.
Harding GKM, Buckwold FJ, Marrie TJ, et al: Prophylaxis of recurrent urinary tract infection in female patients: efficacy of low-dose thrice-weekly therapy with trimethoprim-sulfamethoxazole. JAMA 242: 1975–1977, 1979.
Vosti KL: Recurrent urinary tract infections: prevention by prophylactic antibiotics after sexual intercourse. JAMA 231: 934–940, 1975.
Brooks D, Maudar A: Pathogenesis of the urethral syndrome in women and its diagnosis in general practice. Lancet 2: 893–898, 1972.
Chariton CAC, Cattell WR, Canti G, et al: The non-urethral syndrome. Brumfitt W, Asscher AW (eds) Urinary Tract Infection. Oxford University Press, London, 1973, pp 173–177.
Cattell WR, Brooks HL, McSherry MA, et al: Approach to the frequency and dysuria syndrome. Kidney Int 85. 8: S138–S143, 1975.
Meares EM: Prostatitis: a review. Urol Clin N Am 2:3– 27, 1975.
Meares EM, Stamey TA: Bactériologie localization patterns in bacterial prostatitis and urethritis. Invest Urol 5: 492–518, 1968.
Stamey TA, Bushby SRM, Bragonje J: The concentration of trimethoprim in prostatic fluid: non-ionic diffusion or active transport? J Infect Dis 128: S686–S690, 1973.
Smith JW, Jones SR, Reed WP, et al: Recurrent urinary tract infections in men: characteristics and response to therapy. Ann Intern Med 91: 544–548, 1979.
Gleckman R, Crowley M, Natsios GA: Therapy of recurrent invasive urinary-tract infections of men. N Engl J Med 301: 878–880, 1979.
Stamm WE: Guidelines for prevention of catheter-associated urinary tract infections. Ann Intern Med 82: 386–390, 1975.
Martin CM, Bookrajian EN: Bacteriuria prevention after indwelling urinary catheterization: a controlled study. Arch Intern Med 110: 703–711, 1962.
Warren JW, Piatt R, Thomas RJ, et al: Antibiotic irrigation and catheter-associated urinary-tract infection. N Engl J Med 299: 570–573, 1978.
Kunin CM: Tendency of vesicoureteric reflux to disappear coincident with specific antimicrobial therapy. In: Kincaid-Smith P, Fairiey KF (eds Renal Infection and Renal Scarring. Mercedes, Melbourne, 1970, pp 287–292.
Hodson CJ, Maling TMJ, McManamon PJ, et al: The pathogenesis of reflux nephropathy (chronic atrophic pyelonephritis). Br J Radiol (Suppl) 13: 1–26, 1975.
Torres VE, Velosa JA, Holley KE, et al: The progression of vesicoureteral reflux nephropathy. Ann Intern Med 92: 776–784, 1980.
Smellie JM, Normand ICS: Bacteriuria, reflux and renal scarring. Arch Dis Child 50: 581–585, 1975.
Normand C, Smellie J: Vesicoureteric reflux: the case for conservative management. In: Hodson J, Kincaid-Smith P (eds) Reflux Nephropathy. Masson Publishing, New York, 1979, pp 281–286.
Kunin CM: A ten year study of bacteriuria in schoolgiris: final report of bacteriologic, urologie and epidemiologic findings. J Infect Dis 122: 382–393, 1970.
Kunin CM: The natural history of recurrent bacteriuria in schoolgiris. N Engl J Med 282: 1443–1448, 1970.
Manners BTB, Grob PR, Dulake C, et al: The interrelationships of asymptomatic bacteriuria, acute bacterial pyelonephritis and bacterial cystitis in women. In: Brumfitt W, Asscher AW (eds) Urinary Tract Infection. Oxford University Press, London, 1973, pp 186–194.
Kaitz AL: Urinary concentrating ability in prepant women with asymptomatic bacteriuria. J Clin Invest 40: 1331–1338, 1961.
Percival A, Brumfitt W, DeLouvois J: Serum-antibody levels as an indication of clinically inapparent pyelonephritis. Lancet 2: 1027–1033, 1964.
Miall WE, Kass EH, Ling J: Factors influencing arterial pressure in the general population in Jamaica. Br Med J 2: 497–506, 1962.
Kass EH: Horatio at the orifice: the significance of bacteriuria. J Infect Dis 138: 546–557, 1978.
Norden CW, Kass EH: Bacteriuria of pregnancy - A critical appraisal. Annu Rev Med 19: 431–470, 1968.
Condi AP, Brumfitt W, Reeves DS, et al: The effects of bacteriuria in pregnancy on foetal health. In: Brumfitt W, Asscher AW (eds) Urinary Tract Infection. Oxford University Press, London, 1973, pp 108–116.
Williams JD, Reeves DS, Brumfitt W, et al: The effects of bacteriuria in pregnancy on maternal health. In: Brumfitt W, Asscher AW (eds) Urinary tract Infection. Oxford University Press, London, 1973, pp 103–107.
Harris R, Thomas V, Shelokov A: Asymptomatic bacteriuria in pregnancy: antibody-coated bacteria, renal function, and intrauterine growth retardation. Am J Obstet Gynecol 126: 20–25, 1976.
Forland M, Thomas V, Shelokov A: Urinary tract infections in patients with diabetes mellitus: Studies on antibody-coating of bacteria. JAMA 238: 1924–1926, 1977.
McCabe WR: Gram-negative bacteremia. Adv Intern Med 19: 135–158, 1974.
Wolff S: Biological effects of bacterial endotoxins in man. J Infect Dis 128: S259–S264, 1973.
Winslow EJ, Loeb HS, Rahimtoola SH, et al: Hemodynamic studies and results of therapy in 50 patients with bacteremic shock. Am J Med 54: 421–432, 1973.
Schumer W: Steroids in the treatment of clinical septic shock. Ann Surg 184: 333–341, 1976.
Gloor FJ: Changing concepts in pathogenesis and morphology of analgesic nephropathy as seen in Europe. Kidney Int 13: 27–33, 1978.
Murray T, Goldberg M: Chronic interstitial nephritis: etiologic factors. Ann Intern Med 82: 453–459, 1975.
Lindvall N: Radiological changes of renal papillary necrosis. Kidney Int 13: 93–106, 1978.
Chinn RH, Maskell R, Mead JA, et al: Renal stones and urinary infection: a study of antibiotic treatment. Br Med J 2: 1411–1413, 1976.
Nemoy MJ, Stamey TA: Surgical, bacteriological and biochemical management of infection stones. JAMA 215: 1470–1476, 1971.
Kleeman SET, Freedman LR: The finding of chronic pyelonephritis in males and females at autopsy. N Engl J Med 263: 988–992, 1960.
Kimmelstiel P, Kim OJ, Beres JA, et al: Chronic pyelonephritis. Am J Med 30: 589–607, 1961.
Freedman LR: Chronic pyelonephritis at autopsy. Ann Intern Med 66: 697–710, 1967.
Schechter H, Leonard CD, Scribner BH: Chronic pyelonephritis as a cause of renal failure in dialysis candidates. JAMA 216: 514–517, 1971.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1984 Martinus Nijhoff Publishing, Boston/ The Hague/ Dordrecht/ Lancaster
About this chapter
Cite this chapter
Forland, M. (1984). The Management of Urinary Tract Infections. In: Suki, W.N., Massry, S.G. (eds) Therapy of Renal Diseases and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3807-9_16
Download citation
DOI: https://doi.org/10.1007/978-1-4613-3807-9_16
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-3809-3
Online ISBN: 978-1-4613-3807-9
eBook Packages: Springer Book Archive