Definition

A significant bacteriuria in the presence of

symptoms
Lodgment and multiplication of bacteria in the
urinary tract from pelvis to bladder
Bacteria most often of faecal origin
Common causes of acute UTIs:
50-70% = E. coli strains
5-15% = Klebsiella pneumoniae
5-15% = Enterobacteriaceae or enterococci

Urinary Tract
Only lower part of urethra has a resident bacterial flora
Rest of the urinary tract is normally sterile

Urinary Tract Infection

Upper urinary tract Infections:
Pyelonephritis
Lower urinary tract infections
Cystitis (traditional UTI)
Urethritis (often sexually-transmitted)
Prostatitis

Definitions
Bacteriuria

Presence of bacteria in the urine

Pyuria

Presence of WBCs in the urine

Cystitis

UTI associated with superficial mucosa o f

bladder

Pyelonephritis

UTI of renal parenchyma and or collection system

Uncomplicated UTI

Infection involving structurally and functionally

normal urinary tract (simple UTI)

Complicated UTI

Infection involving structurally and functionally

abnormal urinary tract

Urethritis

Infection of the urethra

4

Causative agents
Community

-acquired
Escherichia coli
Proteus mirabilis
Klebsiella
pneumoniae
Enterococcus
faecalis
Staphylococcus
species

Hospital acquired
Pseudomonas
aeruginosa
Candida albicans
AND (community

acquired)
Mycobacterium
tuberculosis (renal TB )

Urinary Tract Infection

(UTI)
Background
1.
Bacterial infections of urinary tract are a
very common reason to seek health services
2.
Common in young females and uncommon
in males under age 50
3.
Common causative organisms
a. Escherichia coli (gram-negative enteral
bacteria) causes most community acquired
infections
b. Staphylococcus saprophyticus, grampositive organism causes 10 15%
c. Catheter-associated UTIs caused by gramnegative bacteria: Proteus, Klebsiella, Seratia,
Pseudomonas

Urinary Tract Infection

Normal mechanisms that maintain sterility of
(UTI)
urine
a.
b.

Adequate urine volume

Free-flow from kidneys through urinary
meatus
c. Complete bladder emptying
d. Normal acidity of urine
e. Peristaltic activity of ureters and
competent ureterovesical junction
f. Increased intravesicular pressure
preventing reflux
g. In males, antibacterial effect of zinc in
prostatic fluid