Infections of the urinary tract are very common. Most women will have at least one urinary tract infection in their lives. UTI has a prevalence of about 1-3% in women, rising to 20% in those over 65 years.

The organisms that normally cause UTI are:

• E. Coli

• Proteus

• Klebsiella

• Enterobacter

• Candida

• Enterococci

• Staphylococci

With abnormalities of the urinary tract, more unusual organisms are found, such as:

• Pseudomonas aeruginosa

• Staphylococcus epidermidis Occasionally, organisms secondary to systemic disease arising elsewhere also cause UTI such as:

• Tuberculosis

• Salmonellosis

• Adenovirus types 2 and 11, in children

• Herpes simplex Risk factors for the development of a urinary tract infection include:

• Diabetes mellitus

• Pregnancy

• Impaired voiding of the bladder

• Genitourinary malformation

• Prostatic hypertrophy in men

• Renal stones

Treatment :
In primary care, in a woman with uncomplicated cystitis urinary culture is not necessarily required. Urine DR is sufficient. Urine microscopy, culture and sensitivity is required in patients with recurrent or complicated infections, during pregnancy.

Further investigations may be indicated if there are recurrent UTIs in woman or a single episode in man e.g. ultrasound, IVU. A child with a single episode of a urinary tract infection require referral for specialist investigation. A short course of antibiotic might be needed. The patient is advised to take plenty of fluid.

Research has shown that three days of antibiotic therapy is similar to 5-10 days in achieving symptomatic cure for uncomplicated urinary tract infection (UTI) in non-pregnant women aged 18-65 years. Although longer treatment is more effective in achieving bacteriological cure, it is associated with more adverse effects.

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