ABSTRACT
Bacterial adherence to the urothelial surface is the first step in the progress of a urinary tract infection. Colonisation and therefore infection rates are higher in women due to the shorter length of the urethra. An X-ray and ultrasound of the kidneys, ureters and bladder is indicated in cases of repeated cystitis in a woman or a single urinary tract in a male to exclude urinary stones and upper tract abnormalities. Urinary dipstick analysis is used to detect pus cells (leucocyte esterase test) and bacteria converting nitrate to nitrite (nitrate reductase test). Urinary tract infection is common in pregnancy and pyelonephritis, prior to the advent of antibiotics, was responsible for premature delivery and perinatal mortality. Pregnant women are now screened for bacteriuria at the first ante-natal visit and antibiotic prophylaxis commenced if positive. Prophylactic antibiotics are also indicated in children with more than three urinary tract infections in 6 months.
