| Clinical
Features |
Ranges from painful urination in
uncomplicated urethritis or cystitis to severe systemic illness
associated with abdominal or back pain, fever, sepsis and
decreased kidney function in some cases of pyelonephritis. |
| Etiologic
Agent |
Usually caused by Escherichia
coli, but other Enterobacteriaceae are also important
causes of infection. |
| Incidence |
In the United States, urinary track
infections (UTIs) account for about 4 million ambulatory-care
visits each year, representing about 1% of all outpatient
visits. |
| Sequelae |
Severe infections associated with
sepsis can be fatal. |
| Transmission |
Usually through fecal contamination
of the urinary tract. |
| Risk
Groups |
General population, but sexually
active women are at highest risk for disease. |
| Surveillance |
Surveillance is conducted through
the National Ambulatory Care Survey. |
| Trends |
Increasing antibiotic resistance
among E. coli and other Enterobacteriacae to many commonly
used antibiotics; interest in muscosal vaccines for prevention
of UTIs in high-risk groups; and judicious use of antibiotics
for treatment of infections. |
| Challenges |
Identifying methods for prevention
of UTIs; evaluating the clinical importance of antimicrobial
resistance in persons with both cystitis and acute uncomplicated
pyelonephritis; and developing guiding principles for judicious
use of antibiotics for persons with suspected UTIs. |
| Opportunities |
Mucosal vaccines for prevention
of UTIs in high-risk populations. Emergency rooms and clinics
for high-risk patients may provide useful settings for research
on UTIs. Improved use of antibiotics in treatment of suspected
UTIs may reduce antimicrobial resistance. |
|
December 2003
|
