title: [Urinary tract infections].
abstract: Urinary tract infections occur very frequently in the community and in hospitalized patients and are mainly caused by Escherichia (E.) coli. Depending on virulence determinants of uropathogenic microorganisms and host-specific defense mechanisms, urinary tract infections can manifest as cystitis, pyelonephritis (bacterial interstitial nephritis), bacteremia or urosepsis. Uncomplicated urinary tract infections in otherwise healthy women should be treated for 3-7 days depending on the antibiotic therapy chosen, even if spontaneous remission rates of up to 40% have been reported. Antibiotics of the first choice for empirical treatment of uncomplicated urinary tract infection are fluoroquinolones, pivmecillinam and fosfomycin. A huge problem is the increasing antimicrobial resistance of uropathogenic microorganisms. Complicated urinary tract infections associated with anatomical and/or functional abnormalities of the urinary tract and/or comorbidities such as diabetes or immunosuppressive therapy, need longer antibiotic treatment (e.g. 10-14 days) as well as interdisciplinary diagnostic procedures. Treatment of community acquired urosepsis includes cephalosporins of the third generation, piperacillin/tazobactam or ciprofloxacin. For nosocomial urosepsis the combination with an aminoglycoside or a carbapenem is recommended.
authors.affiliation: Klinische Abteilung für Nephrologie und Dialyse, Medizinische Universitätsklinik III, Wien, Österreich. walter.hoerl@meduniwien.ac.at
authors.forename: W H
authors.initials: WH
authors.lastname: Hörl
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D001682:Biological Availability; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D004926:Escherichia coli / Q000276:immunology / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors; D051193:Toll-Like Receptors / Q000502:physiology; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D037521:Virulence Factors
chemical_list: D000900:Anti-Bacterial Agents; D051193:Toll-Like Receptors; D037521:Virulence Factors