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Organisms

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E.coli accounts for 80% of cases - most are due to a specific subset of E.coli (uropathogenic strains). These strains possess specific determinants of virulence that enable them to infect the upper urinary tract of normal, healthy individuals.

  • uropathogenic E.coli belong to a small number of O:K:H serotype groups. They usually produce both haemolysin and aerobactin. Usually they also have specific pyelonephritis associated pili that mediate attachment to uroepithelial cells.

  • other organisms are usually associated with structural abnormality eg proteus, staphylococcus, streptococcus, klebsiella, pseudomonas

  • tuberculosis classically causes a 'sterile' pyruria.

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