Urinary Tract Infection
URINARY TRACT INFECTION
What Is a Urinary Tract Infection (UTI)?
A urinary tract infection (UTI) occurs when one or more parts of the urinary system (kidneys, ureters, bladder, or urethra) become infected with a pathogen (most frequently, bacteria). UTIs most commonly occur in females; about 50% of all females get a UTI during their lifetime. Many UTIs are not serious but if infection reaches the kidneys, serious illness, and even death, can occur.
What Causes Urinary Tract Infection (UTI)?
The vast majority of UTIs start when pathogens (usually bacteria like E. coli ) reach the urethra and then travel up (retrograde) the urethra to the bladder. Urine is usually sterile until it reaches the distal urethra. Women have short urethras compared to men and most clinicians think the shorter urethra is the major reason women have more UTIs than men.
What Are UTI Symptoms? Bladder Infection
Bladder infections are the most common type of UTI. Some individuals may have few or no symptoms; however, the usual symptoms include dysuria (pain or burning during urination), low abdominal pain, and/or urine that is cloudy or smells bad or unusual.
What Are UTI Symptoms? Kidney Infection
Some bladder infections do not resolve and get worse with the pathogens moving up (retrograde) the ureters to the kidneys. Symptoms may include those listed for bladder infections on the pervious slide, but often include other symptoms such as pain in the lower back (flank pain on one or both sides), fever, chills, and nausea and/or
Who Is Most at Risk of Urinary Tract Infection Infection (UTI)?
Risk factors for UTIs were presented previously, but besides being a woman who is sexually active or someone who is elderly or immunocompromised, there are other risk factors:
- Not drinking enough fluids (slows the wash of pathogens out of the body)
- Taking frequent baths (soaking in fluid that may promote retrograde infections)
- Waiting to urinate (promotes retrograde bacterial movement)
- Kidney stones (causes slowing or partial blockage of urine flow)
What Are Symptoms of Urinary Tract Infection in Men?
Adult men have infrequent UTIs; if they get a UTI there usually is an underlying cause (for example, having an enlarged prostate or kidney stone or being an elderly person with a catheter .unprotected sex is also a key factor.
Urinary tract infection (UTI) symptoms
Urinary tract infection (UTI) symptoms can be frightening and a cause for concern. Some people who have a UTI don't have any symptoms. Sometimes a doctor may diagnose a UTI based on the description of the patient's symptoms and ruling out other potential causes. The following slides describe common symptoms of a UTI
Urinary tract infection (UTI) symptoms
Urinary tract infection (UTI) symptoms can be frightening and a cause for concern. Some people who have a UTI don't have any symptoms. Sometimes a doctor may diagnose a UTI based on the description of the patient's symptoms and ruling out other potential causes. The following slides describe common symptoms of a UTI.
Painful urination
Bacteria that grow in the bladder (cystitis) or urethra can cause pain and make it difficult to urinate. People who have UTIs commonly report feeling a burning sensation upon urination
Frequent urination
Urinating more frequently than usual or feeling the need to urinate more frequently are common symptoms of a UTI. Sometimes the urge to urinate is so strong it awakens people at night. An inability to hold urine in the bladder can also be a UTI symptom.
Urine color and clarity
A UTI may be associated with a change in the appearance and odor of urine. Urine may be cloudy due to pus or tinged red due to blood. It's not uncommon for urine to be foul-smelling with a UTI.
Pain and pressure
Men and women with UTIs may experience pain in certain areas. In men affected by UTIs, pain or a feeling of pressure may occur in the rectum. In women with UTIs, the pubic bone area is potentially painful.
Hesitancy to urinate
An inability to completely empty the bladder can be a symptom of a UTI. Difficulty urinating or a strong urge to urinate accompanied by just a small release of urine are also potential symptoms of a UTI.
Generalized urinary tract infection (UTI) symptoms
A UTI may produce symptoms outside of the urinary tract. Weakness and tiredness may be UTI symptoms. If a UTI is located in the bladder or urethra, fever may not be present. If the infection has reached the blood or kidneys, it's more likely fever will occur.
Urinary tract infection (UTI) in infants
Infant boys and girls can suffer from UTIs, but they often experience symptoms different than those in older children and adults. Fever, irritability, poor feeding, and loose stools may occur in babies who have UTIs. Since these symptoms may occur with many other conditions, it can be difficult to diagnose UTIs in infants.
Urinary tract infection (UTI) in the elderly
Elderly individuals may have UTI symptoms that are more difficult to recognize and which complicate diagnosis. Those who live in a health care setting and rely on urinary catheters may be more prone to UTIs.
Who's at Risk of UTI Complications?
Although a bladder infection is not a medical emergency, the following individuals have a higher risk for UTI complications such as infection spread to the kidneys or elsewhere in the body:
- Pregnant women
- People who have diabetes
- Individuals with kidney problems such as kidney stones or blockages
- Elderly individuals
- Immunocompromised patients
- Men with enlarged prostates
- People with urinary retention and/or indwelling catheters
How to Test for Urinary Tract Infection (UTIs)
Urinalysis is usually the first diagnostic test done after a patient presents their medical history and has a physical exam. The test provides information about the presence of bacteria, white and red blood cells, and chemical abnormalities. It can indicate that other studies such as urine culture and bacterial drug sensitivity tests should be done. Simple tests like the urine dipstick test or even home tests of urine can be done but they are not 100% accurate. It is best to have your doctor evaluate your symptoms and test results
How to Treat Urinary Tract Infection (UTIs)
Although severe kidney infections are often treated in the hospital with IV antibiotics, most UTIs (and many mild-to-moderate kidney infections) are treated with oral antibiotics. However, many clinicians are sending urine samples to identify the infecting organisms and determine their antimicrobial resistance. It is not unusual for a doctor to call a patient and switch antibiotics because of antibiotic resistance. In addition, the doctor will usually recommend that the patient take in plenty of fluids (water) and encourage frequent urination to flush bacteria out of the urinary tract.
How to Prevent and Treat Recurrent UTIs
Recurrent UTIs are not unusual; you should ask your primary care physician (PCP) for a referral to a urologist if you have three or more UTIs per year to see if there may be an underlying urinary tract problem that may be the cause. Your PCP may also suggest taking taking an oral antibiotic after sex, or taking an oral antibiotic as needed when UTI symptoms appear.
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