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Urinary tract infections (UTIs)

Urinary tract infections (UTIs) are infections that occur in any part along the urinary tract, such as the bladder, kidneys, ureters or urethra.1

 

Causes

UTIs are mainly caused by bacteria which enter the urinary tract through the urethra. Bacteria may cause infections in the bladder or even the kidneys.1

 

The most common causative agents are Escherichia coli, Staphylococcus aureus, Klebsiella, enterococci bacteria, etc. Chlamydia and Mycoplasma may also cause infection and may be sexually transmitted.2

 

Community-acquired pneumonia (CAP)
The urinary tract is structured to prevent infections. The one-way valves in the ureters prevent urine from flowing back to the kidney. The prostate glands of men produce secretions which inhibit bacterial growth.2
Community-acquired pneumonia (CAP)

Risk factors

Certain factors and conditions may increase the risk of developing UTIs. These include:1,2,3

 

  • Women have a higher risk of UTI than men due to their structural difference in the urinary tract
  • Urinary retention (inability to empty your bladder completely)
  • A urinary catheter inserted into your urinary tract
  • Pregnancy
  • Surgery or other procedures involving the urinary tract
  • Menopause - After menopause, production of oestrogen by the ovaries declines causing changes in the urinary tract that make it more prone to infections

 

  • Advanced age (especially people in nursing homes)
  • Use of diaphragms or spermicides – these agents may promote bacterial growth
  • Sexual activity
  • Other medical conditions including Diabetes mellitus, kidney stones, enlarged prostate, impairment of the immune system, neurogenic bladder, urinary tract abnormalities, etc.

 

How common is it?

In the United States, UTIs are the second most common type of infection in the body, accounting for approximately 8.1 million visits to healthcare providers each year.2 Women are especially prone to UTIs as their urethra is shorter, allowing bacteria to have quicker access to the bladder. In addition, a woman’s urethral opening is near potential sources of bacteria such as the anus and vagina. For women, the lifetime risk of having a UTI is greater than 50%. UTIs in men are less common but can be serious when they occur.2

 

When UTIs are treated promptly and properly they rarely lead to complications. However, if left untreated, a UTI may result in acute or chronic kidney infections with potentially permanent damage to your kidneys. Individuals at high risk of complicated UTIs include the elderly, young children and pregnant women.3

 

Symptoms

Common symptoms of bladder infections include:1

  • Cloudy or bloody urine, which may have a foul or strong odour
  • Low fever (not everyone will have a fever)
  • Painful or burning urination
  • Pressure or cramping in the lower abdomen (usually middle) or back
  • Frequent and intense urge to urinate

 

In case of kidney infections, the patient may present additional symptoms:1

 

  • Chills and shaking or night sweats
  • Fatigue and a general ill-feeling
  • Fever (higher than 101°F or 38.3°C)
  • Flushed, warm, or reddened skin
  • Mental changes or confusion (especially in the elderly)
  • Nausea and vomiting
  • Severe abdominal pain
  • Pain in the back (loin pain)

 

Treatment

Antibiotic treatment is the mainstay for managing UTIs. The choice of medication and length of treatment depend on severity of the disease, patient’s condition, types of UTIs and type of bacteria causing the infection.2

 

In uncomplicated UTI, which occurs in a healthy person with a normal, unobstructed urinary tract, treatment with antibiotics for 2–3 days may be sufficient. However, in complicated cases (eg, pregnant women, transplant patients, structural or functional abnormalities of the urinary tract), longer treatment may be required.2 Commonly used antibiotics include sulfonamides, β-lactams, tetracyclines and fluoroquinolones.3

 

For chronic UTI (UTI which keeps coming back), longer antibiotic therapy or stronger antibiotics may be required.3
If the infection is caused by a structural problem in the urinary tract, surgery may be required.1

 

Tips to recovery:2,3

  • Finish the course of antibiotics
  • Drink plenty of fluids

 

Prevention

Some lifestyle modifications may lower the chance of having UTIs.1,2,3

 

Diet

  • Drinking plenty of water can help remove bacteria from your system through urination
  • Alcohol or caffeine-containing fluids may irritate the bladder and should be avoided

 

Personal hygiene

  • Keep genital areas clean before and after sexual activities
  • Use sanitary pads rather than tampons. These should be changed regularly
  • Shower is preferred to bath
  • Urinate before and after sexual activity
  • Wipe thoroughly from front to back after using the toilet
  • Avoid sprays or perfumes in the genital area

 

Clothing

  • Cotton underwear is preferred
  • Tight pants should be avoided

 

References

1. Urinary tract infections - adults. Medline Plus Web Site. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000521.htm . Accessed 5 June 2012.

 

2. Urinary tract infections in adults. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) Web Site. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/. Accessed 5 June 2012.

 

3. Urinary tract infection. Mayo Clinic Web Site. Available at: http://www.mayoclinic.com/health/urinary-tract-infection/DS00286. Accessed 5 June 2012.

 

The above information is provided for your reference only.

Please consult your family doctor if you have any enquiries.

Disease Information

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