Cystitis is an inflammatory process of the bladder that is nearly always due to a bacterial infection. Acute uncomplicated cystitis can be defined as cystitis in a healthy, young, non-pregnant woman. Acute uncomplicated cystitis is caused by bowel flora that colonizes periurethral tissues and ascends through the urethra, infecting the bladder. About 80% of cases of acute uncomplicated cystitis are caused by Escherichia со//and 10% by Staphylococcus saprophyticus. Most of the remaining infections are caused by Proteus mirabilis, Klebsiella pneumoniae, Entero-bacter species, and beta-hemolytic streptococi.
Asymptomatic bacteriuria is a common occurrence among young, sexually active women. In one study, monthly cultures were performed for 6 months in asymptomatic women, and more than 20% of the women in the study had at least one positive culture finding. However, only 8% of these positive cultures were followed by a symptomatic UTI. This finding supports the practice of treating bacteriuria only in symptomatic individuals. Only under special circumstances (e.g., pregnancy, preceding urologic procedures) is it appropriate to treat asymptomatic bacteriuria.
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