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Vol. 36. Issue 1.
Pages 48-53 (January 2012)
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Vol. 36. Issue 1.
Pages 48-53 (January 2012)
Review article
Urinary tract infections and their prevention
La infección urinaria y su prevención
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2303
F. González-Chamorroa,
Corresponding author
, R. Palaciosb, J. Alcoverb, J. Camposb, F. Borregoc, D. Dámasod
a Servicio de Urología, Hospital San Rafael, Madrid, Spain
b Diater Laboratorio, Leganés, Madrid, Spain
c Zoster, Grupo Ferrer, Beniel, Murcia, Spain
d Departamento de Medicina Preventiva, Salud Pública y Microbiología, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
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Abstract
Context

This article reviews diverse aspects of the prevention of urinary tract infections, including confirmation of the diagnosis, application of hygiene and dietary measures, antibacterial prophylaxis (preferably consisting of a single nocturnal oral dose per day of an antibiotic or drug with high urinary excretion and good tolerance), and administration of vaccines made with Escherichia coli and other Gram-negative bacilli, consisting of immunostimulating fractions of E. coli strains or E. coli type-1 fimbriae administered through the parenteral or oral route.

Objective

We aimed to review the new preventive measures against urinary tract infections.

Acquisition and synthesis of evidence

We reviewed various microbiological aspects, as well as the physiopathology and virulence factors of uropathogenic E. coli strains expressing type-1 and P fimbriae. The association between blood groups and urinary tract infections in blood group antigen-secretors and nonsecretors was analyzed.

Conclusions

New preventive measures against urinary tract infection consist of the use of phenol-inactivated vaccines administered via the mucosal route, inhibitors of bacterial adherence and biofilm formation, and cyclic adenosine monophosphate stimulators, especially in women aged between puberty and menopause, who show the highest incidence of these infections.

Keywords:
Urinary infection
Adherence
Fimbriae
Biofilms
Vaccines
Resumen
Contexto

En este artículo se revisan diferentes aspectos acerca de la prevención de las infecciones del tracto urinario que incluyen: la confirmación de la existencia de dichas infecciones, la aplicación de medidas higiénico-dietéticas, la profilaxis antibacteriana —preferentemente la toma de una única dosis nocturna diaria oral de un antibiótico o quimioterápico con elevada excreción urinaria y buena tolerancia—, la administración de vacunas elaboradas con Escherichia coli y otros bacilos gramnegativos completos con fracciones inmunoestimulantes o fimbrias tipo 1 de E. coli por vías parenteral u oral.

Objetivo

Revisión de las nuevas medidas de prevención de las infecciones del tracto urinario.

Adquisición y síntesis de evidencia

Se revisan diferentes aspectos microbiológicos, la fisiopatología y los factores de virulencia de E. coli uropatógenos productores de fimbrias de tipos 1 y P. Se analiza la relación entre los grupos sanguíneos y la infección del tracto urinario en los individuos secretores y no secretores.

Conclusiones

El uso de vacunas inactivadas con fenol y administradas por vía mucosa, el empleo de inhibidores de la adherencia y de la formación de biopelículas bacterianas y el uso de estimuladores del adenosín-monofosfato cíclico se presentan como nuevas medidas preventivas de la infección urinaria, particularmente para el grupo de mayor incidencia, representado por las mujeres entre la pubertad y la menopausia.

Palabras clave:
Infección urinaria
Adherencia
Fimbrias
Biopelículas
Vacunas

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