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Pathophysiology:
The bacteria that cause urinary tract infections typically enter the bladder via the urethra. However, infection may also occur via the blood or lymph. It is believed that the bacteria are usually transmitted to the urethra from the bowel, with females at greater risk due to their anatomy. After gaining entry to the bladder, E. Coli are able to attach to the bladder wall and form a biofilm that resists the body's immune response.
Disease statistics:
The statistics and drug sensitivity tests of bacterial florae isolated from the urinary tract in 1983 and 1984 were reviewed. Of the 2,222 strains isolated from outpatients, 593 (26.7%) were gram positive cocci, 21.4% were E. coli, 11.3% were Enterococcus, 10.4% were Proteus sp., 10.0% were P. aeruginosa, 5.6% were Alcaligenes sp., 4.2% were S. epidermidis and the rest were others.
Treatment:
Treatment with antimicrobials aims to eradicate the bacteria causing infection. The chosen antimicrobials depend on extent of infection (uncomplicated or complicated), common local pathogens, and resistance patterns.
Examples of antibiotics for uncomplicated UTI include: Trimethoprim-sulfamethoxazole; Fluoroquinolones; Nitrofurantoin
Research:
Uva ursi has a long history of use for urinary conditions in Japan. Until the development of sulfa antibiotics, its principal active component, arbutin, was frequently prescribed by physicians as a treatment for bladder and kidney infections. It appears that the arbutin contained in uva ursi leaves is broken down in the intestine to another chemical, hydroquinone. This is altered a bit by the liver and then sent to the kidneys for excretion. Hydroquinone then acts as an antiseptic in the bladder. (It is, however, potentially quite toxic.)
