From Phylameana lila Desy,
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UTI's occur in a small percentage of infants due to congenital abnormalities that sometimes require surgery. They are rarely seen in boys and young men, but the rate of UTI's in females gradually increases as they age. Scientists are not sure why women have more urinary infections than men. One factor may be that in women the urethra is short, allowing easy migration of bacteria to the bladder. Also, a woman's urethral opening is near sources of bacteria from the anus and vagina. For many women, sexual intercourse seems to precipitate an infection. The reasons for this association are unclear, but some doctors think that, in women predisposed to vaginal colonization of bacteria, intercourse may propel bacteria in to the urethra.

Yet another factor is the method of birth control: according to several studies, women who use the diaphragm are more likely to develop a UTI than women who use other forms of contraception.

UTI's are a recurrent problem for many women, also for reasons that are poorly understood. In the vast majority of cases, the new infection stems from a strain or type of bacteria that is different from the infection that preceded it. (Even when several infections in a row are traced to E. coli, there are usually slight differences in the bacteria, indicating that each infection was caused by a distinct strain.)

Researchers at Tulane University in New Orleans, supported by the National Institute of Diabetes and Digestive and Kidney Diseases, suggest that one factor behind recurrent UTI's may be the ability of bacteria to adhere to the mucous tissue of the urinary tract. Another may be that local immune responses in some women are less effective in preventing the growth of bacteria.

Pregnant women seem no more susceptible to UTI's than nonpregnant women. However, when an infection does occur, it may be more serious because it is more likely to travel to the kidneys. According to some reports, about 2 to 4 percent of pregnant women develop a urinary tract infection. Scientists think that hormonal changes and shifts in the positioning of the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For this reason, many doctors recommend periodic testing of the urine. A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery of her baby and other risks such as high blood pressure and toxemia. In selecting an antibacterial drug, the physician considers both its effectiveness and toxic effects to the fetus.

Symptoms

Not everyone with a urinary tract infection has symptoms, but most people get at least some. Such symptoms include a frequent urge to urinate and a painful, burning feeling during urination. It is not unusual to feel bad all over--tired, shaky, washed out--and to feel pain even when not urinating. Often, women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum. It is common for a person with a urinary infection to complain that, despite the urge to urinate, only a small amount of urine is passed. The urine itself may appear milky or cloudy--even reddish if blood is present. A fever may indicate that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

In children, symptoms of urinary infection often are not noticed, or they may be attributed to some other disorder. A UTI should be considered when a child, or infant, seems irritable, is not eating normally, vomits, has incontinence or loose bowels, or is not thriving. The child should be seen by a doctor if there are any questions about these symptoms, especially when accompanied by increased frequency of urination.

Diagnosis

A urinary infection can easily be diagnosed by testing a sample of urine for the presence of pus and bacteria. A "clean catch" urine sample is obtained by washing the genital area and collecting a "midstream" sample of urine in a sterile container. (This method of collecting a urine sample helps prevent bacteria around the genital area from contaminating the urine and confusing the test results.) Usually, the sample is sent to a laboratory, although some doctors' offices are equipped to do the testing on site. First, the urine is examined for white and red blood cells and bacteria in a test called urinalysis. The bacteria then are grown in a culture and tested against various antibiotics to determine which drug most effectively destroys the bacteria. This step is called a sensitivity test.