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neurogenic bladder and female sexual trauma with obstruction and reflux being the most common (Huether & McCance, 2017). Upper UTI’s occur most commonly in women and have a high risk for the development of sepsis. The organisms responsible are e.coli from contamination of GI tract and Proteus and Pseudomonas widely associated with urethral instrumentation or after urinary surgery (Huether & McCance, 2017). Symptoms of lower UTI’s may precede the acute onset of symptoms related to upper UTI’s. Upper UTI symptoms include fever, chills, flank or groin pain, rigors and or confusion (especially in elderly patients (Mulryan, C, 2011). Patient Factors: Age and GenderAny child can get a UTI, yet girls get UTIs more often than boys (National Institute of Diabetes and Digestive and Kidney Disease [NIDDK], 2012). Children with a condition called vesicoureteral reflux (VUR), which causes urine to reflux at the point where one or both ureters attach to the bladder, are at higher risk for UTIs (NIDDK, 2012). Infants and young children who get a UTI often have VUR; and boys younger than six months who are not circumcised are at higher risk for a UTI than circumcised boys the same age(NIDDK, 2012).
Women are at an increased risk of developing UTI’s than men, and the risk is further increased in women of childbearing age (Hooton, 2012). The differences in anatomy between men and women are responsible for the increased incidence in women (Lema, 2015). Males have a longer urethra on average, and their urethral meatus is external whereas in females, the urethra is much shorter and the meatus is most often found on the surface of the vulva, though it can open inside the vagina (Mulryan, C, 2011). The