Urinary tract infection

Infection of the genitourinary tract is one of the most common conditions of childhood. Up to 10% of
children will have a Febrile UTI during the first two years of life. Among several boys status in
determining the risk for UTI on circumcised male infants immense of is of the highest prevalence of UTI
may involve the urethra and bladder lower urinary tract are the ureters ,renal pelvis ,calyces and renal
parenchyma (upper urinary tract).

Classification

Infection of the urinary tract maybe present with or without clinical symptoms.

bacteriuria - presence of bacteria in the urine.

Asymptomatic bacteriuria - significant bacteriuria - usually defined as more than 1 lakh Colony forming
units with no evidence of clinical infection.

Symptomatic bacteriuria - accompanied by physical signs of UTI ( dysuria, suprapubic dis comfort,
haematuria, fever)

Recurrent UTI - repeated episode of bacteriuria.

Persistent UTI- persistence of bacteria despite antibiotic treatment.

Febrile UTI - bacteriuria accompanied by fever and other physical science of UTI. Presence of a fever
typically implies pyelonephritis.

Cystitis- inflammation of the bladder

Urethritis- inflammation of the urethra.

Pyelonephritis- inflammation of the upper urinary tract and kidney

urosepsis- febrile UTI co existing with systemic signs of bacterial illness; blood culture reveals presence
of urinary pathogen.

Etiology

E coli (80% of cases) and other gram negative enteric organisms.

Other organisms include proteus, pseudomonas, klebsiella, and haemophilus sPP, staphylococcus aureus.

The short urethra measuring 2 cm in young girls and 4 cm in women provides pathway for invasion of
organisms.

The closure of the urethra at the end of the micturition return contaminated bacteria to the bladder.

The longer male urethra as 20 CM in an adult and the antibacterial properties of prostatic secretions
inhibit the entry and growth of pathogens

Under normal conditions the act of completely and repeatedly eating the bladder clauses away any
organisms. The most after influencing the occurrence of UTI is urinary stasis.
This me result from reflux anatomic abnormalities this function of the boarding mechanism bladder
compression.

Most pathogens favor an alkaline medium.

Increased fluid intake promotes of the normal bladder and lowers the of organisms in the infected
bladder.