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Bacterial urethritis
Last reviewed: 23.04.2024
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Bacterial urethritis is a urological disease in which various variants of staphylococci, streptococci, Escherichia coli, enterococci and other opportunistic microorganisms are present in the discharge from the urethra.
In addition, it is possible to introduce microbes that did not exist on the mucous membrane of the urethra. Identifying the etiologic factor in patients with bacterial urethritis presents certain difficulties, especially for bacteria of the genus Neisseria, which are close in their properties to gonococci.
[Causes of the bacterial urethritis
Bacterial urethritis in women is a serious problem, since infections of the lower urinary tract are rarely isolated. In women with recurrent urinary tract infection, a gram-negative microflora is present in the vaginal environment in 56% of cases, whereas in non-anamnesis of urinary tract infections it was found only in 24% of the examined. With a recurrent urinary tract infection, the vagina of patients is very often colonized with E. Coli, Enterococcus faecalis, Proteus mirabilis and Klebsiella.
In postmenopausal women, due to the decrease in estrogen levels, atrophy of the urogenital mucosa develops in women. The epithelium in the vagina and urethra becomes thin, there is a deficiency of glycogen, the production of lactic acid decreases and the vaginal pH rises. These changes in the vaginal environment contribute to the excessive growth of non-dairy coliform forms of bacteria and the disappearance of lactobacilli, favorable conditions are created for colonizing the vagina with opportunistic and pathogenic microflora. In this case, the frequency of ascending infection of the lower urinary tract (including urethral canal lesions) during the postmenopause increases.
Symptoms of the bacterial urethritis
Symptoms of bacterial urethritis caused by the bacteria of the genera Esherichia colli, Klebsiella, Enterobacter, Serratia, Proteus, Citrobacter, Providencia, depend on the localization of the pathological process and can not be differentiated from infections caused by other bacteria, based solely on the symptoms and signs of the disease.
Therefore, it is very important to determine the causative agent of the infection, including species and type accessory, its quantity in 1 ml of fresh urine and its sensitivity to antibiotics. All this is essential for clarifying the pathogenesis and administration of bacterial urethritis.
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Treatment of the bacterial urethritis
The expressed antimicrobial action on the bacteria of the Enterobacteriaceae family is protected by aminopenicillins, second and third generation cephallosporins, fluoroquinolones, aminoglycosides. However, the sensitivity to these drugs in different strains is not the same, so it must be determined by laboratory methods.
A pronounced therapeutic effect can be achieved with a simultaneous combination of two or more antibacterial drugs depending on the sensitivity to them and taking into account the mixed infection. Bacterial urethritis treatment involves the combination of antibacterial drugs with drugs that potentiate the "antibiotic effect, increasing the protective mechanisms of the body of patients, facilitating the delivery of antibacterial agents to the lesions, providing their therapeutic concentration in tissues and blood serum.