Knowledge And Causes Of Urinary Tract Infection As Perceived By Health Workers
[A CASE STUDY OF KAURA LOCAL GOVERNMENT AREA, KADUNA STATE]

It’s more over said tubular damage to the medulla area of the kidney leads to defects in urine concentration and sodium conservation with polyuria and salt wasting fibrosis progressing into the context lead to loss of excretory function and anaemia when it affects the lower urinary tract it usually begin suddenly and include the following signs.
    A strong urge to urinate frequently, which may occur immediately after the bladder is emptied
    A painful burning sensation when urinating
    Discomfort or pressure in the lower abdomen the abdomen can feel bloated
    Pain in the pelvic area or back
    The urine often has a strong smell, looks cloudy or contains blood. This is a sign of pyuria or high white blood cell count in the urine and very reliable indicator of urinary tract infection occasionally fever develops.
    Some women has three or UTIS in a year they are prone to have frequent infection throughout their lives time.
    Men are less likely than woman to have first UTI but once a man has UTI he is likely to have another because bacteria can hide deep inside the prostrate tissue. Anyone who has diabetes, spinal   cord injuries or a problem that makes it hard to urinate may have repeated infection. Most UTIS are not serious but some infection can lead into serious problem such as kidney infection. Chronic kidney infection that reoccur or last a long time can cause permanent damage including kidney score poor kidney growth poor kidney function and some acute kidney infections that develop suddenly can be life threatening especially if the bacteria enter into the blood stream.
2.2. Causes of Urinary Tract Infection
Causative agent
Urine is generally considered to be sterile and is believed to be germ free. Any source of possible infection occurs through urethra which initiates the incidence of the infection. The predominant pathogen responsible for UTI is E. coli which constitutes up to 80-85% and is followed byStaphylococcus saprophyticus which accounts to 5-10%. The occurrence of the infection due to viral or fungal agents is a rare phenomenon. In addition to the above mentioned bacterial species, Klebsiella, Proteus, Pseudomonas and Enterobacter are associated with UTI. The bacteria enter the bladder through urethra and the infection can also occur through blood and lymph. The microbial etiology of UTIs is deemed to be well established and frequent.
Pathogens like E. coli and S. saprophyticus are associated with population acquired acute uncomplicated infection where as Klebsiella, Enterococcus, Proteus Species , Enterobacter are known to confer uncomplicated cystitis and phylonephritis that are sporadic. Mainstream pathogens associated with UTIs are known for their resilience and exhibit the property of antimicrobial tolerance. In addition, they are also known for their phenotypic and genotypic features that make them prime contenders in conferring the infection. Host factors have to be considered as they are equally responsible for the cause of the infection and make the individual vulnerable. These include age, diabetes, long term hospitalized patients and the kind of medical devices among the patients like the catheters Bonado, M. Meini, M.s PItaleri P and Cugi,C(2001). The bacteria are transmitted to the bladder from the bowel. The attachment of the bacteria is followed by the formation of the bio-film which resists the immune response and is the main cause of the infection. Incidence of UTI due to S. aureus is usually considered as a secondary infection next to blood borne infections. In addition urinary catheters elevate the risk of UTI. Depending on the presence or absence of the symptoms, it is known as symptomatic and asymptomatic UTI. As the name indicates, symptomatic is the condition in which the symptoms are seen in the patient and in case of asymptomatic the symptoms are not found. In both the conditions, the urine will have a considerable count of bacteria. A count of ≥105 to 106 is considered to confirm the presence of symptomatic or asymptomatic bacteriuria during pregnancy. According to researchers, count exceeding 100,000 bacteria/ ml in two consecutive clean catch urine samples or same count in a single mid stream urine sample can be considered as true bacteriuria Bonado, M. Meini, M.s PItaleri P and Cugi,C(2001)