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Review
. 2013 Oct;14(5):448-56.
doi: 10.1007/s11934-013-0354-5.

From physiology to pharmacy: developments in the pathogenesis and treatment of recurrent urinary tract infections

Jennifer A Silverman  1 , Henry L Schreiber 4th, Thomas M Hooton, Scott J Hultgren
Affiliations
Review

From physiology to pharmacy: developments in the pathogenesis and treatment of recurrent urinary tract infections

Jennifer A Silverman et al. Curr Urol Rep. 2013 Oct.

Abstract

Urinary tract infections (UTIs) are common, and over half of women report having had at least one in their lifetime. Nearly a third of these women experience recurrent UTI episodes, but the mechanisms of these recurrences are not fully elucidated. Frequent use of antimicrobials for treatment and prevention of UTIs and other infections has contributed to the evolution of multidrug-resistant microorganisms globally. This is a looming worldwide crisis that has created an urgent need for novel strategies for the treatment and prevention of UTIs. Furthering our understanding of the mechanisms of recurrent UTIs, from both host and bacterial perspectives, will be paramount in developing targeted management strategies. In this review, we discuss recent findings regarding recurrent UTIs in women, including progress in our understanding of the mechanisms of recurrence as well as emerging treatments.

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Conflict of interest statement

Compliance with Ethics Guidelines: Conflict of Interest: Dr. Jennifer A. Silverman and Dr. Henry L. Schreiber IV reported no potential conflicts of interest relevant to this article.

Dr. Thomas M. Hooton serves on the board and owns stock in the company of Fimbrion Therapeutics, Inc.

Figures

Figure 1
Figure 1
Possible modes of UTI recurrence. Recurrent UTIs can be introduced from a number of sources. 1. The same UTI-causing strain (green bacteria) persists in the gut and repeatedly re-inoculates the bladder. 2. A different strain (red bacteria) is introduced first into the gut and then colonizes the bladder. 3. Quiescent bacteria reside in the bladder epithelium and re-emerge periodically to cause same-strain UTI (green bacteria). 4. A new strain of bacteria is introduced directly into the peritoneal area from the environment (blue bacteria).
See this image and copyright information in PMC

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