Pathophysiology

UTI should be thought of as either complicated, that is, occurring in patients with underlying renal or neurologic disease; or uncomplicated, occurring in patients in which no defect can be demonstrated.23 and 4 The most common urinary pathogen is E. coli, which causes greater than 80 percent of uncomplicated UTIs (Tab.!e 90z1). Uropathogenic organisms often have adhesins, fibriae, or pili that allow for bacterial adherence to the uroepithelium. Anaerobic organisms do not grow well in urine and are rarely pathogenic. While complicated UTIs can be caused by E. coli, they are more likely to be caused by unusual pathogens, such as Pseudomonas spp or enterococcus.

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