Types Of Urinary Tract Infections

October 07, 2008

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Types Of Urinary Tract Infections

by Lynn Cates, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.

You may have heard about bladder infections, kidney infections, or E coli infections, and wonder exactly what these terms mean. In general, a urinary tract infection (UTI) is categorized in two ways: first, by its location in the urinary tract (e.g., bladder or kidney), and second, by the exact germ that causes it (e.g., E coli).

Anatomy of the urinary tract
In order to understand urinary tract infections better, it's helpful to know a little basic anatomy. The kidneys produce urine and transport it to the bladder through narrow tubes known as ureters. Urine passes from the bladder to the outside of the body through a short tube known as the urethra. Normally, urine flows in only one direction-from the kidneys down to the bladder and out of the body--because valves at the junction of the bladder and the ureters keep urine from flowing back up (or refluxing) to the kidneys.

In girls and women, the urethra is very short and exits the body between the labia in the genital area. In boys and men, the urethra is longer, extending from the bladder through the length of the penis, exiting the body at the tip of the penis. Since the urethra is much shorter and closer to the rectum in girls than boys, bacteria are much more likely to travel from a girl's rectum to her genital area and on into her bladder. After the newborn period, girls have a much higher rate of urinary tract infections than boys because of these anatomical differences. Other factors are felt to be responsible for boys' having more UTIs in the first few weeks of life.

Kinds of infection by location
Your child's symptoms may vary depending on the location of the infection. Some common names for urinary tract infections based on location are as follows:

Ascending infections are those caused by bacteria that travel from the outside genital area up through the urethra into the bladder. If there is backflow of urine (or reflux) from the bladder up through the ureters , the kidneys also can become infected. The ascending route of infection is by far the most common, particularly in girls and uncircumcised boys.

Bladder infections (or cystitis or lower tract infections ) are infections that are limited to the bladder. They are much more common than kidney infections and usually are less serious. They can lead to problems, however, by extending up to the kidneys if they are left untreated or if they are associated with certain abnormalities of the urinary tract structures (e.g., vesicoureteral reflux, or posterior urethral valves). Bladder infections may cause symptoms like lower abdominal pain (over the bladder); pain, burning, or stinging on urination (dysuria); frequent urination (frequency), and an urgent need to pee (urgency).

Urethritis is irritation of the urethra, and is considered to be a kind of lower-tract infection. It usually is caused by irritants such as stool, soap (especially those containing perfumes), bubble bath, or shampoo in prepubescent girls, and may be due to sexually transmitted diseases such as Chlamydia and gonorrhea in adolescent males and females. Like cystitis, it causes pain with urination (dysuria), frequency, and urgency.

Vulvitis is irritation of the external genitalia in girls and, like urethritis, can be caused by irritants such as soap. Vulvitis can cause the labia to look red and somewhat swollen, and cause pain on urination.

Kidney infections (or pyelonephritis, or upper-tract or renal infections) are infections of the ureters and the tissues of the kidney itself. These infections are less common, but usually more serious, than those of the lower tract. They tend to cause higher fever and more severe disease (including bloodstream infection-or sepsis-and even shock in some cases). They also are more likely to lead to permanent kidney scarring and other complications such as high blood pressure (hypertension).

Kind of infection by organism
The vast majority of urinary tract infections are caused by intestinal bacteria, such as Escherichia coli (E coli) since billions of bacteria normally live in the stool, and the genital region is near the rectum. Some of the other kinds of bacteria found in feces that can cause urinary tract infections include Klebsiella, Proteus, Staphylococcus saprophyticus, Enterobacter species, Pseudomonas, enterococci, and group B streptococci.

Not all urinary tract infections are caused by bacteria. Viruses such as adenovirus also can cause bladder infections. In addition, fungi can cause upper- or lower-tract infections in individuals with decreased immunity (e.g., those on chemotherapy for cancer or have HIV/AIDS).


RELATED INFORMATION

			How Children Get Urinary Tract Infections
			Urinary Tract Infections: Overview
			Urinary Tract Problems

Created February 28, 2001
Reviewed March 12, 2001

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