Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

Privette, Malcolm; Cade, Robert; Peterson, John; Mars, Donald R.

doi:10.1159/000185111

Cited by 55 publications

(18 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding is consistent with other studies and may reflect a high incidence of colonization in postmenopausal women by Gramnegative coliforms bacteria of distal urethra and the introitus. 1,16 Catheter-associated UTIs comprise perhaps the largest institutional reservoir of nosocomial antibiotic-resistant pathogens, the most important of which are multidrug-resistant Enterobacteriacae other than E. coli, such as Klebsiella, Enterobacter, Proteus, and Citrobacter; Pseudomonas aeruginosa; Enterococci and staphylococci; and Candida spp. 17 In our study, we also found, as in Ackermann's study, a higher proportion of non-E. coli Gramnegative organisms in patients with chronic urethral catheters than in patients with no exposure to catheters.…”

Section: Discussionmentioning

confidence: 99%

Profile and prognosis of febrile elderly patients with bacteremic urinary tract infection

Tal

Guller

Levi

et al. 2005

Journal of Infection

129

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Profile and prognosis of febrile elderly patients with bacteremic urinary tract infection

Tal

Guller

Levi

et al. 2005

Journal of Infection

129

View full text Add to dashboard Cite

“…Larsen and colleagues 9 found that women on oestrogen therapy had larger numbers of vaginal lactobacilli compared to those not receiving this hormone who had a mixed aerobic and anaerobic¯ora. Privette and colleagues 18 studied urinary tract infection in postmenopausal women and found that the incidence was reduced by oestrogen therapy alone. These observations are insuf® cient, however, to provide a clear picture of the effect of HRT on the vaginal¯ora.…”

Section: Discussionmentioning

confidence: 99%

Bacterial vaginosis in climacteric and menopausal women

et al. 2002

View full text Add to dashboard Cite

The objective was to determine how frequently an abnormal vaginal flora occurred in women attending a menopause clinic and whether any abnormality might be related to a particular risk factor. Women completed a questionnaire on their gynaecological, sexual and medical history. Whether they were perimenopausal or postmenopausal was determined on the basis of symptomatology, duration of amenorrhoea and on a follicle-stimulating hormone (FSH) assay when clinically indicated. A speculum examination of the vagina was undertaken, at which time a smear of vaginal secretion was Gram stained and the bacterial flora graded as follows: grade 1, normal; grade 2, intermediate, and grade 3, bacterial vaginosis (BV). Of 100 women examined, 44 had grade 1 flora, 17 had grade 2 flora and 18 had BV. An apparent absence of, or very scanty, vaginal bacteria in which grading was not possible was found in 21 women. Women with BV had had more sexual partners than the others, but otherwise there were no discernible factors associated with the occurrence of BV. Women with vaginal atrophy were more likely to have an apparent absence of vaginal bacteria, but a few had BV.

show abstract

“…Prophylactic treatments include estrogen in postmenopausal women (36,41,125,140,198,208,214) or cranberry juice (13,77,200), although the efficacy of the former remains controversial. Treatment of UPEC-infected mice with forskolin, a drug that increases intracellular cyclic AMP (cAMP) levels, expels UPEC from intracellular vesicles into the extracellular milieu, rendering the bacteria susceptible to immune responses and antibiotics (29).…”

Section: Weapons Systems: Current and Proposed Treatments And Vaccinementioning

confidence: 99%

Waging War against UropathogenicEscherichia coli: Winning Back the Urinary Tract

2010

View full text Add to dashboard Cite

Urinary tract infection (UTI) caused by uropathogenic Escherichia coli (UPEC) is a substantial economic and societal burden-a formidable public health issue. Symptomatic UTI causes significant discomfort in infected patients, results in lost productivity, predisposes individuals to more serious infections, and usually necessitates antibiotic therapy. There is no licensed vaccine available for prevention of UTI in humans in the United States, likely due to the challenge of targeting a relatively heterogeneous group of pathogenic strains in a unique physiological niche. Despite significant advances in the understanding of UPEC biology, mechanistic details regarding the host response to UTI and full comprehension of genetic loci that influence susceptibility require additional work. Currently, there is an appreciation for the role of classic innate immune responses-from pattern receptor recognition to recruitment of phagocytic cells-that occur during UPEC-mediated UTI. There is, however, a clear disconnect regarding how factors involved in the innate immune response to UPEC stimulate acquired immunity that facilitates enhanced clearance upon reinfection. Unraveling the molecular details of this process is vital in the development of a successful vaccine for prevention of human UTI. Here, we survey the current understanding of host responses to UPEC-mediated UTI with an eye on molecular and cellular factors whose activity may be harnessed by a vaccine that stimulates lasting and sterilizing immunity. MISSION: ERADICATE UPEC-MEDIATED UTIUrinary tract infection (UTI) is one of the most common infections in humans. Bacteria present in fecal matter inoculate the periurethral area, then the bladder (124, 176, 291), causing symptoms clinically termed cystitis. Left untreated, bacteria ascend the ureters to the kidney and establish a secondary infection, acute pyelonephritis. At this juncture, there is risk of permanent renal scarring, and bacteria can access the bloodstream (282). It is estimated that 40% of women and 12% of men will experience a symptomatic UTI, with incidences peaking in their early 20s or after age 85, respectively (75, 185). Approximately 25% of these women will experience recurrence within 6 to 12 months (75, 185). Uropathogenic Escherichia coli (UPEC) is the most common etiological agent responsible for uncomplicated UTI (93, 94,282). Uropathogenic strains are classified as extraintestinal pathogenic E. coli, a broad grouping of E. coli that cause diseases other than gastroenteritis and typically lack a type III secretion system (171,220,221,283,284). Nonetheless, UPEC strains express an assortment of virulence and fitness factors that aid in successful colonization of the mammalian urinary tract (126,136). In the United States alone, the estimated annual societal cost of UTI is more than 3 billion dollars (159).Despite a relatively in-depth knowledge base for UPEC physiology and virulence mechanisms (reviewed in references 54, 126, 136, and 284), no licensed vaccine to prevent UTI exists in the Un...

show abstract

Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

Cited by 55 publications

References 8 publications

Profile and prognosis of febrile elderly patients with bacteremic urinary tract infection

Profile and prognosis of febrile elderly patients with bacteremic urinary tract infection

Bacterial vaginosis in climacteric and menopausal women

Waging War against UropathogenicEscherichia coli: Winning Back the Urinary Tract

Contact Info

Product

Resources

About