Urinary Tract Infection (UTI)

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Definition

Urinary tract infections (UTIs) are caused by bacteria that invade the urinary system and multiply. The infection can occur in any part of the urinary system, but usually starts in the urethra (a tube that carries the urine out of the body).

The Urinary Tract

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Causes

In most cases, bacteria (usually from the digestive tract and rectal area) begin growing in the urethra. They cling to the opening of the urethra and begin to multiply. An infection limited to the urethra is called urethritis . From there, bacteria often move on to the bladder, causing a bladder infection ( cystitis ). If the infection is not treated promptly, bacteria may then go up the ureters (two tubes that carry urine from the kidneys to the bladder) to infect the kidneys ( pyelonephritis ).

Most infections arise from one type of bacteria, E. coli , which normally lives in the colon. In women, since the rectum and urethra are fairly close to each other, the bacteria can migrate into the urethra. This makes women more prone to urinary tract infections than men.

UTIs can also be sexually transmitted. This type of infection usually does not spread past the urethra. Both partners need to be treated in the case of a sexually transmitted infection. Risk Factors A risk factor is something that increases your chance of getting a disease or condition. Sex: femaleBeing sexually activeUsing a diaphragm for birth controlMenopauseDiabetesKidney stonesEnlarged prostateWeak immune system Abnormalities of the urinary system, including vesicoureteral reflux , polycystic kidneysParaplegiaSickle-cell anemia History of kidney transplantBladder catheter in place, or recent instrumentation of the urinary systemPregnancy Symptoms Symptoms include: Frequent and urgent need to urinatePassing small amounts of urinePain in the abdomen or pelvic areaBurning sensation during urinationCloudy, bad-smelling urineIncreased need to get up at night to urinateBlood in the urineLeaking urineLow back pain or pain along the side of the ribsFever and chillsNausea and poor appetiteNote: Bloody urine, low back pain, a high fever, and chills are all signs of a kidney infection . Call your healthcare provider immediately.
DiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. A sample of your urine will also be tested for blood, pus, and bacteria.Children and men who develop UTIs may require additional testing. There may be structural abnormalities of the urinary system that predispose them to infection. TreatmentUrinary tract infections are treated with antibiotic drugs. Standard medical care for an uncomplicated UTI includes the prescription of antibiotics for three days. You most likely will start to feel better after a day or two. However, it is important that you continue to take the entire course of medication.You may be asked to have your urine checked after you finish taking the antibiotic. This is to make sure that the infection is truly gone.If you still experience recurrent infections, you may be referred to a specialist.Pyridium is a medicine that decreases pain and bladder spasm. When taken, it may turn your urine, and sometimes your sweat, an orangish color. In some cases, severe UTIs are treated with intravenous or intramuscular antibiotics. Researchers, though, found that oral antibiotics appear to be as effective in treating UTIs as other treatments. * Prevention Here are some steps you can take to help keep bacteria out of the urinary tract:
Drink plenty of liquids.Urinate when you feel the need and do not resist the urge.Empty your bladder completely and drink a full glass of water after having sex.Wash genitals daily.Take showers instead of baths.If you are a woman, always wipe from the front to the back after having a bowel movement.Avoid using douches and feminine hygiene sprays.Drinking cranberry juice may help prevent and relieve UTIs. RESOURCES: American Foundation for Urologic Diseasehttp://www.afud.org National Kidney and Urologic Diseases Information Clearinghousehttp://kidney.niddk.nih.gov/index.htm CANADIAN RESOURCES: Canadian Urological Associationhttp://www.cua.org/ Women's Health Mattershttp://www.womenshealthmatters.ca/index.cfm References: American Foundation for Urologic Disease website. Available at: http://www.afud.org . Accessed October 13, 2005. Car J. Urinary tract infections in women: diagnosis and management in primary care. BMJ. 2006;14;332. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/ . Accessed October 13, 2005. Sheffield JS, Cunningham FG. Urinary tract infection in women. Obstet Gynecol. 2005;106:1085-1092.
*12/5/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections [review]. Cochrane Database of Systematic Reviews. 2007(4). DOI: 10.1002/14651858.CD003237. Last reviewed December 2007 by Jill Landis, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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