Periurethral enterobacterial carriage preceding urinary infection

Area of Science:

• Urology
• Microbiology
• Infectious Diseases

Background:

• Recurrent urinary tract infections (UTIs) are common, particularly in women.
• The role of periurethral and perineal bacterial colonization in recurrent UTIs requires further elucidation.

Purpose of the Study:

• To investigate the relationship between periurethral enterobacterial flora and infective episodes in patients with recurrent UTIs.
• To determine if the infecting strain is consistently present in the periurethral area during infection.

Main Methods:

• Prospective identification of periurethral enterobacterial flora in 56 patients before infective episodes.
• Analysis of 91 infection episodes for bacterial colonization patterns (infecting strain, no colonization, heterologous colonization).
• Comparison with a separate group of 54 women investigated during an enterobacterial UTI.

Main Results:

• In recurrent UTI patients, only 34% of episodes involved colonization with the infective strain.
• No perineal colonization was observed in 31 episodes, and heterologous colonization occurred in 29.
• In a separate group, 86% of UTI episodes showed colonization with the infecting organism, with 11% having heterologous strains.

Conclusions:

• Women with recurrent UTIs exhibit susceptibility to perineal and periurethral colonization by gram-negative bacteria.
• Urinary tract infections may not always be caused by the enterobacteria colonizing the periurethral area.