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Cited by 190Urinary Tract Infections ManagementEscherichia coli research studiesBladder and Urothelial Cancer Treatments

Urinary tract infections: pathogenesis, host susceptibility and emerging therapeutics

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Timm, Morgan R., Russell, Seongmi K., Hultgren, Scott J.·2025·Nature Reviews Microbiology
DOI 10.1038/s41579-024-01092-4PMC PMC13194463
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Abstract

Urinary tract infections (UTIs), which include any infection of the urethra, bladder or kidneys, account for an estimated 400 million infections and billions of dollars in health-care spending per year. The most common bacterium implicated in UTI is uropathogenic Escherichia coli, but diverse pathogens including Klebsiella, Enterococcus, Pseudomonas, Staphylococcus and even yeast such as Candida species can also cause UTIs. UTIs occur in both women and men and in both healthy and immunocompromised patients. However, certain patient factors predispose to disease: for example, female sex, history of prior UTI, or the presence of a urinary catheter or other urinary tract abnormality. The current clinical paradigm for the treatment of UTIs involves the use of antibiotics. Unfortunately, the efficacy of this approach is dwindling as the prevalence of antimicrobial resistance rises among UTI isolates, and the immense quantity of antibiotics prescribed annually for these infections contributes to the emergence of resistant pathogens. Therefore, there is an urgent need for new antibiotics and non-antibiotic treatment and prevention strategies. In this Review, we discuss how recent studies of bacterial pathogenesis, recurrence, persistence, host-pathogen interactions and host susceptibility factors have elucidated new and promising targets for the treatment and prevention of UTIs.

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  • Antibiotic resistance in UTIs is increasing owing to the worldwide spread of such infections and the widespread use of antibiotics as the gold standard therapy for UTIs.

    “Antibiotic resistance in UTIs is increasing owing to two major factors: the worldwide spread of such infections and the widespread use of antibiotics as the gold standard therapy for UTIs [17].”

    From Vaginal microbiota and urinary tract infections in women: the protective role of vaginal lactobacilli in counteracting urinary tract infections occurrence and recurrence (2026) · cites this paper as [17]

    The Introduction says antibiotic resistance in UTIs is rising, and the Abstract says the large quantity of antibiotics prescribed for UTIs contributes to resistant pathogens. The Introduction also describes UTIs as a global health problem, but the paper does not identify the worldwide spread of infections as a cause of rising resistance. Page numbers were not provided in our copy. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Timm, M. R., Russell, S. K., & Hultgren, S. J.
Affiliations
Washington University in St. Louis (US)
Corresponding author
Hultgren, Scott J.
ORCID
Venue
Nature Reviews Microbiology
Publisher
Springer Science and Business Media LLC
Published
2024-09-09
Volume
23
Issue
2
Pages
72-86
ISSN
  • 1740-1526 (ISSN-L)
  • 1740-1534
DOI
10.1038/s41579-024-01092-4
PMC
PMC13194463
OpenAlex
W4402366396
Cited by
190
References
2
Citations by year
2026: 112 · 2025: 75 · 2024: 3
FWCI
11.52
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Reviews Microbiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
Funders
  • National Institute of Allergy and Infectious Diseases (R01AI048689, R01AI029549, U19AI157797)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK132327, T32DK077653, R01DK121822, F30DK135390)
Topics
  • Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
  • Health Sciences › Medicine › Surgery › Bladder and Urothelial Cancer Treatments
Keywords
urinary tract infection, uropathogenic Escherichia coli, Klebsiella, Enterococcus, Pseudomonas, Staphylococcus, Candida, host susceptibility, host-pathogen interaction, antimicrobial resistance, antibiotic resistance, recurrent urinary tract infection, bacterial persistence, catheter-associated urinary tract infection, risk factors
MeSH terms
Anti-Bacterial Agents, Bacteria, Disease Susceptibility, Female, Humans, Male, Urinary Tract Infections, Host-Pathogen Interactions

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