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Candida Urinary Tract Infection: Pathogenesis

Fisher, John F. and Kavanagh, Kevin and Sobel, Jack D. and Kauffman, Carol A. and Newman, Cheryl A. (2011) Candida Urinary Tract Infection: Pathogenesis. Clinical Infectious Diseases, 52 (S6). S437-S451. ISSN 1058-4838

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Abstract

Candida species are unusual causes of urinary tract infection (UTI) in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. The urinary tract may be invaded in either an antegrade fashion from the bloodstream or retrograde via the urethra and bladder. Candida species employ a repertoire of virulence factors, including phenotypic switching, dimorphism, galvano - and thigmotropism, and hydrolytic enzymes, to colonize and then invade the urinary tract. Antegrade infection occurs primarily among patients predisposed to candidemia. The process of adherence to and invasion of the glomerulus, renal blood vessels, and renal tubules by Candida species was elegantly described in early histopathologic studies. Armed with modern molecular biologic techniques, the various virulence factors involved in bloodborne infection of the kidney are gradually being elucidated. Disturbances of urine flow, whether congenital or acquired, instrumentation of the urinary tract, diabetes mellitus, antimicrobial therapy, and immunosuppression underlie most instances of retrograde Candida UTI. In addition, bacterial UTIs caused by Enterobacteriaceae may facilitate the initial step in the process. Ascending infections generally do not result in candidemia in the absence of obstruction.

Item Type: Article
Additional Information: The definitive version of this article is available at Clinical Infectious Diseases (2011) 52 (suppl 6): S437-S451. doi: 10.1093/cid/cir110 This article appears in: Candida Urinary Tract Infections
Keywords: Candida; Urinary Tract Infection; Pathogenesis;
Subjects: Science & Engineering > Biology
Item ID: 3789
Depositing User: Dr. Kevin Kavanagh
Date Deposited: 04 Jul 2012 15:25
Journal or Publication Title: Clinical Infectious Diseases
Publisher: Oxford University Press
Refereed: Yes
URI:

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