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Abstract(s)
As infeções urinárias são resultado da invasão e multiplicação de patogenos, maioritariamente bactérias, ao longo do trato urinário. A recorrência destas infeções é um problema bastante comum e preocupante. A população do sexo feminino é o grupo mais afetado por questões anatómicas e fisiológicas.
As mulheres na pós-menopausa são um grupo específico em que as infeções recorrentes estão associadas à diminuição de estrogénios enquanto que nas mulheres em idade fértil, os principais fatores de risco são as relações sexuais frequentes, o uso de espermicidas e múltiplos parceiros sexuais.
As infeções recorrentes têm dois principais mecanismos para patogénese: a ascensão repetida e frequente do agente ou a persistência do mesmo na bexiga. A Escherichia coli uropatogénica é o patogeno mais frequente, sendo deste modo o mais bem estudado. Para além deste, microrganismos como a Klebsiella pneumoniae, o Proteus mirabilis e o Staphylococcus saprophyticus poderão causar ITU.
Para que o patogeno possa colonizar o trato urinário, este apresenta fatores de virulência, como adesinas, toxinas, flagelo e mecanismos de captação de ferro.
Embora a terapêutica antibiótica seja a mais eficaz no tratamento de ITU, a resistência dos microrganismos tem vindo a crescer drasticamente. Deste modo, deve-se optar por terapêuticas profiláticas, como é o caso da imunoterapia, dos Lactobacillus e dos estrogénios.
As infeções do trato urinário são um problema de saúde pública, onde é importante perceber os potenciais métodos a adotar de modo a prevenir recorrências.
Urinary tract infections result from the presence of pathogens, bacteria mostly, in the urinary tract. The recurrence of these infections is a very common and worrying problem. The female population is the most affected group by anatomical and physiological issues. Postmenopausal women are a specific group in which recurrent infections are associated with a decrease in oestrogens whereas, in sexually mature women, the main risk factors are related relationships, use of spermicides and multiple sexual partners. Recurrent infections have two main mechanisms for pathogenesis: a repeated and frequent ascent of the agent or persistence of the same in the bladder. Uropathogenic Escherichia coli is the most frequent pathogen, thus being the most well studied. Besides, microorganisms such as Klebsiella pneumoniae, Proteus mirabilis and Staphylococcus saprophyticus can cause UTI. In order to colonize the urinary tract, the pathogen express virulence factors, such as adhesins, toxins, flagella and iron-uptake mechanisms. Although antibiotic therapy is the most effective in the treatment of UTI, the resistance of microorganisms has been growing dramatically. Therefore, prophylactic therapies should be chosen, such as immunotherapy, Lactobacillus and oestrogens. Urinary tract infections are a public health problem, where is important to adopt potential methods to prevent recurrences.
Urinary tract infections result from the presence of pathogens, bacteria mostly, in the urinary tract. The recurrence of these infections is a very common and worrying problem. The female population is the most affected group by anatomical and physiological issues. Postmenopausal women are a specific group in which recurrent infections are associated with a decrease in oestrogens whereas, in sexually mature women, the main risk factors are related relationships, use of spermicides and multiple sexual partners. Recurrent infections have two main mechanisms for pathogenesis: a repeated and frequent ascent of the agent or persistence of the same in the bladder. Uropathogenic Escherichia coli is the most frequent pathogen, thus being the most well studied. Besides, microorganisms such as Klebsiella pneumoniae, Proteus mirabilis and Staphylococcus saprophyticus can cause UTI. In order to colonize the urinary tract, the pathogen express virulence factors, such as adhesins, toxins, flagella and iron-uptake mechanisms. Although antibiotic therapy is the most effective in the treatment of UTI, the resistance of microorganisms has been growing dramatically. Therefore, prophylactic therapies should be chosen, such as immunotherapy, Lactobacillus and oestrogens. Urinary tract infections are a public health problem, where is important to adopt potential methods to prevent recurrences.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2020, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Infeções do trato urinário Recorrência Fatores de virulência Tratamento Mestrado integrado - 2020