Controversies in Urinary Tract Infection

  • S. Grant Mulholland
  • Kenneth Weisman
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 224)


There has been some controversy in the past concerning the pathogenesis of urinary tract infection. The routes of infection considered to be of significance are: the ascending or retrograde route; the lymphatic route; and the hematogenous route. It is now felt that the urinary tract, especially in the female, is infected in a retrograde fashion. The female is autoinfected from her own stool. The bacteria colonize the perineum then progress to the vagina, urethra, bladder and possibly the kidneys. In an infection prone female, the prelude to the infection is colonization of the vagina with gram negative bacteria (1). In the female who does not have a history of urinary tract infection or who is not prone to urinary tract infection, colonization of the vagina with typical urinary pathogens is not a common event.


Urinary Tract Urinary Tract Infection Recurrent Urinary Tract Infection Resistant Organism Symptomatic Urinary Tract Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    T.A. Stamey. The role of introital enterobacteria in recurrent urinary infections. J. Urol. 109: 467 (1973).PubMedGoogle Scholar
  2. 2.
    S.G. Mulholland, S.K. Qureshi, R.W. Fritz, and H. Silverman. Effect of hormonal deprivation on the bladder defense mechanism, J. Urol. 127: 1010–1013 (1982).PubMedGoogle Scholar
  3. 3.
    C.L. Parsons, C. Greenspan, S.W. Moore, and S.G. Mulholland. Role of surface mucin in primary antibacterial defense of bladder. Urol. 9: 48 (1977).PubMedCrossRefGoogle Scholar
  4. 4.
    K. Weisman, H. Callahan, H. Cooper, R. Fritz, and S.G. Mulholland. Decrease in rabbit mucosal glycoproteins after oophorectomy. J. Urol. 132: 380–383 (1984).PubMedGoogle Scholar
  5. 5.
    C. Svanborg-Eden and H. Leffler. Glycosphigolipids of human urinary tract epithelial cells as possible receptors for adhering Escherichia coli bacteria. Scand. J. Dis. Suppl. 24: 144 (1980).Google Scholar
  6. 6.
    S.G. Mulholland, M. Mooreville and C.L. Parsons. Urinary tract infections and P blood group antigens. Urol. 24: 232–235 (1984).PubMedCrossRefGoogle Scholar
  7. 7.
    T.A. Stamey. Urinary infections in infancy and childhood. Chapter 6, pgs. 290–294 in Pathogenesis and Treatment of Urinary Tract Infections, T.A. Stamey, (ed.), Williams & Willaims, Baltimore/London (1980).Google Scholar
  8. 8.
    J. Winberg, H.J. Andersen, T. Bergstrom, B. Jacobsson, H. Larson and K. Lincoln. Epidemiology of symptomatic urinary tract infection in childhood. Acta. Paediatr. Scan, (suppl.) 252: 3 (1974).Google Scholar
  9. 9.
    G.L. Rolleston, F.T. Shannon, and W.L.F. Utley. Relationship of infantile vesicoureteric reflux to renal damage. Br. Med. J. 1: 460 (1970).PubMedCrossRefGoogle Scholar
  10. C.M. Kunin. An overview of urinary tract infection, pgs. 39–47 in Detection, Prevention and Management of Urinary Tract Infections, C.M. Kunin, (ed.), 3rd edition. Lea & Feibinger, Philadelphia, PA (1979).Google Scholar
  11. 11.
    C.M. Kunin, and R.C. McCormack. An epidemiologic study of bacteriuria and blood pressure among nuns and working women. N. Engl. J. Med. 278: 635–642 (1968).PubMedCrossRefGoogle Scholar
  12. 12.
    W.R. Fair, B.L. McClennan and R.G. Jost. Are excretory urograms necessary in evaluating women with urinary tract infection? J. Urol. 121: 313 (1979).PubMedGoogle Scholar
  13. 13.
    W.R. Fair, D.B. Crane, L.J. Peterson, C. Dahmer, B. Tague, and W. Amos. Three day treatment of urinary tract infections. J. Urol. 123: 717 (1980).PubMedGoogle Scholar
  14. 14.
    D.I. Rosen. Five day course of antibacterials for uncomplicated urinary infections. Urol. 8: 450 (1976).PubMedCrossRefGoogle Scholar
  15. 15.
    R.N. Gruneberg, and W. Brumfitt. Single-dose treatment of acute urinary tract infection: a controlled trial. Br. Med. J. 3: 649 (1967).PubMedCrossRefGoogle Scholar
  16. 16.
    L.S.T. Fang, N.E.T. Rubin and R. Rubin. Efficacy of single-dose and conventional amoxicillin therapy in UTI localized by the antibody-coated bacteria technique. N. Engl. J. Med. 298: 413 (1978).PubMedCrossRefGoogle Scholar
  17. 17.
    G.K.M. Harding, F.J. Buckwald, T.J. Marrie, L. Thompson, R.B. Light and A.R. Ronald. Prophylaxis of recurrent urinary tract infection in female patients: Efficacy of low-dose thrice weekly therapy with trimethoprim-sulfamethoxazole. J.A.M.A. 242: 1975, Nov. 2 (1979).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • S. Grant Mulholland
    • 1
  • Kenneth Weisman
    • 1
  1. 1.Department of UrologyJefferson Medical CollegePhiladelphiaUSA

Personalised recommendations