Hooton T M
Department of Medicine, University of Washington School of Medicine, Seattle, USA.
J Antimicrob Chemother. 2000 Sep;46 Suppl 1:1-7; discussion 63-5.
The pathogenesis of uncomplicated urinary tract infection (UTI) is complex and influenced by many host biological and behavioural factors and by properties of the infecting uropathogens. Most uncomplicated UTIs in women are not associated with underlying functional or anatomical abnormalities of the urinary tract, whereas sexual intercourse, spermicide use, a history of recurrent UTI and recent antimicrobial chemotherapy are important risk factors. A maternal history of UTI and young age at first UTI, as well as sexual intercourse and spermicide use, are risk factors for recurrent UTI in young women. In some young healthy women, especially those with 'low UTI risk' behaviour, features of pelvic anatomy appear to be associated with UTI risk. In postmenopausal women, anatomical and functional characteristics of the genitourinary tract are more strongly associated with UTI risk than in younger women. A genetic predisposition to recurrent UTI is suggested by the association of recurrent UTI in certain age groups with the ABH blood group non-secretor phenotype, a maternal history of UTI and early age at onset of UTI. Virulence determinants of uropathogens are much more important in the normal host than in the host who has a functional or anatomical abnormality of the genitourinary tract.
单纯性尿路感染（UTI）的发病机制复杂，受许多宿主生物学和行为因素以及感染性尿路病原体特性的影响。大多数女性单纯性UTI与尿路潜在的功能或解剖异常无关，而性交、使用杀精剂、复发性UTI病史以及近期的抗菌化疗是重要的危险因素。母亲有UTI病史、首次发生UTI时年龄较小，以及性交和使用杀精剂，都是年轻女性复发性UTI的危险因素。在一些年轻健康女性中，尤其是那些有“低UTI风险”行为的女性，盆腔解剖结构特征似乎与UTI风险相关。在绝经后女性中，泌尿生殖道的解剖和功能特征与UTI风险的关联比年轻女性更强。某些年龄组的复发性UTI与ABH血型非分泌型表型、母亲的UTI病史以及UTI发病年龄较早之间的关联提示存在复发性UTI的遗传易感性。尿路病原体的毒力决定因素在正常宿主中比在泌尿生殖道有功能或解剖异常的宿主中更为重要。
