Title: Urinary Tract Infections
Headings: URINARY TRACT INFECTIONS (Urethritis, Cystitis, Pyelonephritis)
URINARY TRACT INFECTIONS (Urethritis, Cystitis, Pyelonephritis)
Etiology
Manifestations
Epidemiology
Risk factors for UTI’s:
Pathogenesis
Diagnosis
Diagnosis should also involve the determination of the site of infection (i.e., kidney or bladder-urethra). This may be suggested by the clinical manifestations and preliminary lab tests.
Therapy and Prevention
A. The clinical manifestations determine the initial step in therapy.
B. General guidelines

Content: Strict anaerobic bacteria rarely cause UTI’s. 75-90% of acute UTI’s in patients with normal anatomic structure and function are caused by uropathogenic strains of E coli. Ten to 20% of acute UTI’s are caused by coagulase-negative Staphylococcus saprophyticus (young sexually active females) and 5% or less are caused by other gram negative rods (Klebsiella, Proteus, Citrobacter) or Enterococcus species. A high pH in the urine is indicative of a Proteus infection. Staphylococcus saprophyticus is a common inhabitant of the gastrointestinal tract. Young women are more susceptible than other ages of women. Sexual intercourse promotes colonization and infections are more common in the late summer to fall seasons. S saprophyticus is the second most common cause of uncomplicated urinary tract infections (UTI) in sexually active young (13-40 years of age) women following E coli. In complicated cases of UTI, such as UTI's resulting from anatomic obstructions, from catheterization, or diabetes the most common cause of UTI is E. coli. Klebsiella, Proteus, Citrobacter, Acinetobacter, Morganella and Pseudomonas aeruginosa are less common causes of UTI in these patients.