Which pathogen is primarily associated with urinary tract infections in older women?

Escherichia coli is the most common pathogen associated with urinary tract infections (UTIs), particularly in older women. This bacterium is a normal inhabitant of the gastrointestinal tract, yet it can easily ascend into the urinary system, especially in individuals with anatomical or functional predispositions such as urinary retention, pelvic floor weakness, or other factors that may affect urinary flow.

In older women, hormonal changes following menopause can also lead to changes in the urogenital flora, which may reduce the protective mechanisms against UTI, making E. coli infections more likely. Its ability to adhere to uroepithelial cells through fimbriae enhances its virulence, contributing to the higher incidence of UTIs in this demographic.

Other pathogens listed may also cause UTIs, but they are less frequently involved in the typical presentations seen in older women. For instance, while Candida albicans can cause urinary tract infections, it is generally more associated with patients who are immunocompromised or have been exposed to certain antimicrobial therapies. Staphylococcus aureus and Enterococcus faecalis are less commonly isolated in uncomplicated urinary tract infections compared to E. coli.

Understanding the predominance of E. coli in this context helps to explain the treatment approaches typically employed