Causative Agents

Bladder infections usually originate from the normal intestinal flora. Specific strains of Escherichia coli cause most cases of bacterial cystitis, accounting for 80% to 90% of cystitis cases in women during the reproductive years and about 70% of all bladder infections. Other enterobacteria such as Klebsiella and Proteus species account for 5% to 10%, and the Gram-positive species, Staphylococcus saprophyticus, accounts for another 5% to 10% of infections in young women. Hospitalized patients are more likely than outpatients to have bladder infections with bacteria such as the Gram-negative rods Serratia mnarcescens and Pseudomonas aeruginosa and the Gram-positive coccus Enterococcus faecalis, that are resistant to antibacterial medications. Those with longstanding bladder catheters are often chronically infected with multiple species of intestinal bacteria. ■ Pseudomonas, pp. 250, 697

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