Urinary Tract Infection (UTI)

Definition

Urinary tract infection is a medical condition characterized by infection of the urinary tract including the kidney, ureters, bladder and urethra. Symptoms of urinary tract infection depend upon the site of infection. Infections in the lower urinary tract infection leads to symptoms like difficulty in urination with passage of blood whereas spread of infection to the upper urinary tract leads to symptoms like flank pain and fever.


Bacteria are the main cause of urinary tract infection but in some cases virus and even fungi may be responsible. Females are at increased risk of developing urinary tract infections due to their shorter urethra. Antibiotics are the mainstay of treatment as most infections are bacterial in nature.

Symptoms

Urinary tract infections may sometimes not lead to symptoms particularly in the elderly and young people. The location of the infection in the urinary tract can determine the symptoms. This includes :

  • Infection in the kidney (pyelonephritis) presents with flank pain, high fever with chill and rigor, nausea and vomiting.
  • Infection in the bladder presents with increased pressure felt at the pelvis, discomfort in the lower abdomen and frequent urination with burning sensation and pain.
  • Infection in the urethra (urethritis) presents with painful passage of urine along with burning sensation. The urine may appear cloudy or red, pink or cola-colored because of the presence of blood. It may have a strong odor and there may be associated lower abdominal or rectal pain.
  • Fever is a common presenting symptom but can sometimes be absent.

Urinary tract infection may lead to number of complications like repeated episodes of infection especially in the women, permanent damage in the kidney leading to impaired renal function following repeated urinary tract infections especially in children and increased risk of low birth weight or early termination of pregnancy before completion of the 37th week in pregnant women with UTI.

Causes

Infecting bacteria typically leads to urinary tract infection after entering the bladder through the urethra. This is known as an ascending infection although the microbes may spread via lymph or the bloodstream. Usually the bacteria enter the urethra from the rectum. After entering the bladder the most commonly infecting bacteria E.coli attaches to the bladder wall and produces a protective covering thereby blocking the immune defenses of the body.

The most common infecting organisms responsible for urinary tract infection are bacteria such as :

  • Escherichia coli (80 to 85%)
  • Staphylococci
  • Klebsiella
  • Proteus
  • Pseudomonas
  • Enterobactor

Other than bacteria viruses or fungi may also be responsible although these are uncommon pathogens in urinary tract infections.

Risk factors

Common risk factors include :

  • Women of any age group are at increased risk of suffering from urinary tract infection as the urethra is much shorter and closer to the anal opening in comparison to males.
  • Young sexually active women and post menopausal women as they lack the protective cover of estrogen.
  • Patients with inserted urinary catheters are at a greater risk especially of Staphylococcus aureus infections.
  • Diabetics.
  • Uncircumcised males.
  • Enlarged prostate.
  • Spinal cord injury.
  • Young children with vesicoureteral reflux.

Treatment

Urinary tract infections are sometimes taken very lightly by patients but it is a serious infection with very dangerous complications. Adequate bed rest and fluid intake are an important part of treatment. Medical treatment options for UTIs include :

  • Prescribing appropriate antibiotic for adequate duration depending upon the infecting organism.
  • Adequate fluid replacement with use of cranberry juice.
  • Applying estrogen cream locally in postmenopausal women.

More Related Topics