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DOI: 10.1055/s-2005-872625
© Georg Thieme Verlag Stuttgart · New York
Ursachen der rezidivierenden Harnwegsinfektionen: neue Erkenntnisse
New insights into the pathogenesis of urinary tract infectionPublication History
eingereicht: 31.5.2005
akzeptiert: 16.8.2005
Publication Date:
06 September 2005 (online)

Glossar
HWI = Harnwegsinfekt
THP = Tamm-Horsfall-Protein
TLR = Toll-like-Rezeptor
UPEC = uropathogene Escherichia coli
IL = Interleukin
IFN-γ = Interferon-gamma
TNF-α = Tumornekrosefaktor-alpha
Harnwegsinfektionen (HWI) zählen zu den am häufigsten vorkommenden bakteriellen Infektionskrankheiten im klinischen Alltag. Jährlich treten schätzungsweise 150 Millionen Fälle von HWI auf, so dass die gesundheitsökonomische Belastung außerordentlich groß ist. In der Regel betrifft der unkomplizierte HWI, der definitionsgemäß nicht mit funktionellen oder anatomischen Abnormitäten des Urogenitaltraktes vergesellschaftet ist, junge, sonst gesunde Frauen: Die Inzidenz beträgt 0,5 - 0,7 pro Jahr; 25 - 30 % von ihnen erleiden Rezidive [8].
In den letzten Jahren wurden deutliche Fortschritte im Verständnis der komplexen Beziehung zwischen Bakterien, bakteriellen Virulenzfaktoren und dem Immunsystem des Wirtsorganismus gemacht. Die physiologischen Mechanismen, die eine Erregerpersistenz oder eine ständige Infektion des Urogenitaltraktes mit uropathogenen Keimen verhindern, sind jedoch noch weitgehend ungeklärt. Im folgenden Artikel sollen die prinzipiellen Mechanismen der bakteriellen Abwehr im Urogenitaltrakt besprochen und mögliche Erklärungen einer erhöhten Suszeptibilität für rezidivierende HWI diskutiert werden.
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Dr. Marcus Säemann
Innere Medizin III, Abteilung für Nephrologie und Dialyse, Medizinische Universität
Wien
Währinger Gürtel 18 - 20
A-1090 Wien
Phone: ++43/1/404005593
Fax: ++43/1/404004392
Email: marcus.saemann@meduniwien.ac.at