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The purpose of study urinary tract infection

Identify the etiology of UTIs , and their


susceptibility in four category in thamer city
Prevalence of infection varies markedly among
sex and age
Considered the second disease of the commonest
familial disease
The high cost that spent from hospital and from
patient for treatment
Considered one of commonest source for
bacteremia in Yemen
There are many way for bacterial infection may
be from blood , lymph ,ascending from urethra and
from vesicoureter reflux

Introduction
infections (UTIs) are a common cause of morbidity
in children. UTI causes significant illness in the
first 2 years of life, particularly when associated
with anatomical abnormalities , vesicoureter reflux
is the most commonly associated with abnormality,
and reflux nephropathy is important cause of end-
. stage renal disease in children and aldoscents
Misdiagnosis very often leads to avoidable ill health and long-
term renal damage. At least 8% of girls and 2% of boys have
urinary tract infections in childhood, and between 30% and 40%
have another episode within two years.3 Male to female ratio
was 1:104. Nearly all UTIs are ascending infection. The
bacteria arise from the fecal flora, colonize the perineum, and
enter the bladder via the urethra. In uncircumcised boys the
bacterial pathogens arise from the flora beneath the prepuce.
.UTIs are much more common in uncircumcised boys

The flora greatly changes with skin commensals


after circumcision. Circumcision might be beneficial
from this point of view.5 Present guideline recommends
that empiric treatment should be started in all cases of
suspected UTIs after an appropriate urine specimen is
obtained to avoid severe illness. The use of an
inappropriate antibiotic will delay effective treatment and
increase the risk of renal scarring that is associated with
chronic renal failure later in life. Diagnosis cannot be
made on urinalysis and other findings alone. Quantitative
urine culture before initiation of antimicrobial therapy is
considered to be the gold standard for diagnosis of
bacterial UTIs.9 Antimicrobial susceptibility testing help
in selection of appropriate treatment for patients with
confirmed bacterial UTI.10
An African study reported that Escherichia coli
(32%) and Proteus spp. (22%) form more than 50% of
the total isolates .The aim of this study was to estimate
the frequency of urinary tract infection in children subjected
.to urine culture and to determine the highly effective antibiotics

in Al Mukalla the bacterial agent of urinary tract


infections among137 pregnant women in Al Mukalla
maternity hospital from January to June 2002. Urine
samples were examined for UTI microscopically and by
culture, and sensitivity tests were done for the organisms
isolated using a range of antibiotics. This study showed
that 30% of the women suffered from UTI; Escherichia coli
was the most frequently isolated organism (41.5%), and it
was highly susceptible to chloramphenicol, ciprofloxacin,
ceftizoxime and amikacin. Of the variables examined,
53.7% of the infected women were in the age group 15-24
years, 48.8% were in their 3rd trimester and 75.6% had 1-
3 children. Urinary tract infection are most commonly
caused by members of enterobacteriaceae and other
bacteria ( Yemen journal .. 2003 ) . Symptomatic urinary tract
infections occur in about 1.4 per 1000 newborn infants , with slight male
. ( preponderance ( Alreak ,. 2003

E.Coli is the most common cause of acute , uncomplicated


Urinary tract infection , occurs more frequently in females
than males . it cause about 70-80% of Urinary tract
infection, however the prevalence of various with
( geographical location (Green Wood , 2002