IMMUNOCOMPROMISED: NO higher risk for UTI!

This week we have discussed urinary tract infection and the different bacteria involved. And I would love to discuss with you the risk of UTI in immunocompromised patients.

In contrary to common believe that immunocompromised patients are at higher risk for urinary tract infection, several studies have shown that the defect in humoral or cellular immunity in immunocompromised patients do not seem to predispose to higher risk for UTI but it affects the clinical symptoms, severity, microbiology, and complications of the infection once the patient has a urinary tract infection.

The frequency of urinary tract infections in immunosuppressed patients other than diabetics or renal transplant recipients is not superior to the frequency of urinary tract infections in non-immunosuppressed patients. The higher incidence of infection seen in renal transplant patients is more related to the period of invasive bladder catheterization rather than to the patient immunocompromised condition.

Because of Neutropenia, urinary tract infection predisposes the patient to bacteremia. Thus, broad-spectrum antibiotics have to be used, which leads to modifications in normal flora, further promoting urinary tract infections with resistant nosocomial pathogens, and can also predispose to fungal infection in the urinary tract.

In urinary tract infection, a functionally and anatomically intact urinary tract and kidney are the main host defenses, with immune mechanisms and phagocytic function playing an important role to LIMIT THE CONSEQUENCES of those infections.

 Diagnostic approach to UTI:

                                           http://www.aafp.org/afp/1999/0301/p1225.html