| 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 faecal 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. |
