Urinary tract infections (UTIs), which include any infection of the urethra, bladder or kidneys, account for an estimated 400 million infections and billions of dollars in health-care spending per year. The most common bacterium implicated in UTI is uropathogenic Escherichia coli, but diverse pathogens including Klebsiella, Enterococcus, Pseudomonas, Staphylococcus and even yeast such as Candida species can also cause UTIs. UTIs occur in both women and men and in both healthy and immunocompromised patients. However, certain patient factors predispose to disease: for example, female sex, history of prior UTI, or the presence of a urinary catheter or other urinary tract abnormality. The current clinical paradigm for the treatment of UTIs involves the use of antibiotics. Unfortunately, the efficacy of this approach is dwindling as the prevalence of antimicrobial resistance rises among UTI isolates, and the immense quantity of antibiotics prescribed annually for these infections contributes to the emergence of resistant pathogens. Therefore, there is an urgent need for new antibiotics and non-antibiotic treatment and prevention strategies. In this Review, we discuss how recent studies of bacterial pathogenesis, recurrence, persistence, host–pathogen interactions and host susceptibility factors have elucidated new and promising targets for the treatment and prevention of UTIs.

尿路感染 (UTI)，包括尿道、膀胱或肾脏的任何感染，估计每年造成 4 亿例感染，并导致数十亿美元的医疗支出。与尿路感染有关的最常见细菌是泌尿道致病性大肠杆菌，但包括克雷伯菌属、肠球菌属、假单胞菌属、葡萄球菌属、甚至酵母菌（例如念珠菌属）在内的多种病原体也可引起尿路感染。女性和男性、健康患者和免疫功能低下的患者都会发生尿路感染。然而，某些患者因素会导致疾病：例如女性、既往尿路感染病史或存在导尿管或其他尿路异常。目前治疗尿路感染的临床范例涉及使用抗生素。不幸的是，随着尿路感染分离株中抗菌素耐药性患病率的上升，这种方法的功效正在减弱，并且每年针对这些感染开出的大量抗生素导致了耐药病原体的出现。因此，迫切需要新的抗生素和非抗生素治疗和预防策略。在这篇综述中，我们讨论了最近关于细菌发病机制、复发、持久性、宿主-病原体相互作用和宿主易感因素的研究如何阐明了治疗和预防尿路感染的新的和有希望的目标。