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KMID : 1240020210250030192
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International Neurourology Journal
2021 Volume.25 No. 3 p.192 ~ p.201
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What is the Cause of Recurrent Urinary Tract Infection? Contemporary Microscopic Concepts of Pathophysiology
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Kim A-Ram
Ahn Jae-Hak
Choi Woo-Suk
Park Hyoung-Keun
Kim Se-Hwan
Paick Sung-Hyun
Kim Hyeong-Gon
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Abstract
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Urinary tract infections (UTIs) are the most common infectious disease and are mainly caused by Escherichia coli. In this review, we introduce the current concept of recurrent UTI (rUTI) based on recent research dealing with pathophysiology of the disease. Although urine is considered sterile, recent studies dealing with microbiome have proposed different ideas. UTIs have typically been considered as extracellular infections, but recently, uropathogenic Escherichia coli (UPEC) has been shown to bind and replicate in the urothelium to make intracellular bacterial communities. Binding UPECs might proceed in many ways including extracellular expulsion for clearance or survival and quiescent intracellular reservoirs that can cause rUTI. Moreover, it is also suggested that other important factors, such as lipopolysaccharide and multimicrobial infection, can be the cause of rUTI. This review article reveals a key mechanism of recurrence and discusses what makes a pathway of resolution or recurrence in a host after initial infection.
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KEYWORD
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Escherichia coli, Cystitis, Urinary tract infection, Recurrence
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