Urinary tract infections in women.

Bacteriuria in the adult female is properly classified according to the pathogenesis and frequency of the infectious process. The vast majority of infections are reinfections that are characterized by sequential infections caused by different organisms. Reinfections result from inoculation of bladder urine in the sterile urinary system by enterobacteria from the vaginal flora and may be occasional or frequent. Susceptibility to frequent reinfections is due to enhanced colonization of the vaginal mucosa by enterobacteria. Persistent infections are characterized by sequential infections caused by the same organism. These infections, which are always frequent, usually result from the continued inoculation of urine by an infected focus within the urinary system. Because of the expense of health care, the efficacy of antimicrobial therapy for reinfections, and the infrequency of serious morbidity associated with reinfections, the rationale for traditional components of patient management has been questioned. An analysis of diagnostic and treatment options and recommendations for the management of bacteriuric women seen by the urologist has been presented.