Bacterial Tolerance vs. Urinary Acid, Urea, and Osmolarity. Infection begets Infection Even aside from the relief of acute symptoms, the prevention and treatment of urinary tract infections is important because each infection makes subsequent infections more likely. A number of vicious pathological spirals may ensue. Lower tract infection leads to upper tract infection. Infected bladders lead to better adherence.
Renal infection decreases ability to concentrate.
Although the urine is normally sterile in the bladder, collected urine is frequently contaminated by small numbers of bacteria from the perineum and urinary meatus. The absolute number and type of bacteria found on culture of fresh urine are helpful in distinguishing true cystitis from nonsignificant bacturia. Therefore treat only symptomatic infection. Bacturia in girls predicts adult bacturia risks. Candiduria is common.