E Coli and Its Colonization of Urothelial Cells - Literature review Example

Acute uncomplicated urinary infection occurs when it presents as acute cystitis (Rubin, Shapiro, Andriole, Davis, & Stamm, 1992). Individuals with acute cystitis may also have non-obstructive pyelonephritis. Asymptomatic bacterial infection also occurs, where a urine specimen will show the presence of infective bacteria, but no symptoms of the urinary tract infection are observed. The infection can be recurrent because the source of the infection is harboured within the urinary tract. Complicated urinary tract infections occur in individuals who have abnormalities in the genitourinary tract.

In women, increased volume of residual urine, bladder diverticulitis, and cystoceles contribute to the recurrence of UTIs. For older males, benign prostate hypertrophy with urethral obstruction, chronic bacterial prostatitis, and turbulent urine flow often lead to urinary tract infection. Urinary tract infection has also been found to be a function of genetic predisposition and a higher frequency of abnormalities in genitourinary organs (Raz, et al., 2000). UTI is common in the elderly population.

Aside from age-related genitourinary abnormalities, the increase in urinary infections in the elderly population is attributed to the use of indwelling devices like catheters (Nicolle, 2001). Clinical manifestations of symptomatic UTI are bladder infection, irritation of the lower tract including incontinence, dysuria, the urgency to urinate, suprapubic pain, and fever (Bentley, Bradley, High, Schoenbaum, Taler, & Yoshikawa, 2000). In patients with indwelling catheters, symptoms could include costovertebral angle tenderness that is more associated with pyelonephritis and fever even when there are no genitourinary symptoms (Orr, et al., 1996). The symptoms are associated with trauma due to insertion of the device or the infection from several microorganisms of the biofilm coating the catheter surface. 1.2.

Enterobacteriaceae are Gram-negative rods that mostly grow well at 37°C and are facultatively anaerobic, catalase-positive and oxidase-negative (Health Protection Agency, 2010). They are widely distributed in different habitats and may be found in animals, plants, soil, and water. Several genera of Enterobacteriaceae are involved in the development of human diseases. Common genera include species of Citrobacter, Enterobacter, Escherichia, Klebsiella, Morganella morganii, Proteus, Providencia, Salmonella, Serratia, Shigella and Yersinia (Health Protection Agency, 2010). 1.3.

Escherichia coli The most important infective organism in UTI is Escherichia coli, but other Enterobacteriaceae species like Klebsiella, Citrobacter and Enterobacter also cause UTIs. Proteus mirabilis, and Providencia stuartii and Morganella morganii, which are urease producers, are also common. Other species identified in patients with UTI are Pseudomonas aeruginosa, enterococci, group B streptococci and coagulase-negative staphylococci. Yeast strains Candida albicans, C. tropicalis, C. glabrata, and C. parapsilosis have also been isolated mostly from patients with indwelling catheters, and diabetes mellitus (Nicolle, Urinary tract pathogens in complicated urinary infection and in the elderly, 2001). E. coli originating from an individual’s intestinal tract is the most common source of UTI (Russo & Johnson, 2003).