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Article title: Urinary Tract Infections: DBMD
Conditions: Urinary Tract Infections
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 fecal 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 UTIs; 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.
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