Urinary Tract Infection- A Concern Of Most Women
Medikoe Health Expert
Koramangala, bengaluru, karnataka, india, Bengaluru Feb 12, 2017
Urinary tract infection or UTI is an infection in any part of your urinary system including kidney, bladder, ureters and urethra.
Urinary tract infections are caused by microbes that are not visible to the naked eye. The infection is most commonly caused by bacteria that affect the lower tract which is your bladder and urethra. The upper tract consists of your ureters and kidneys which are rarely affected but in case they are, the condition is more serious.
Statistically, one in 10 men will get urinary tract infection in their lifetime. The number is much higher for women, 1 in 2 women get UTI, most of them might also have repetitive infections.
Signs and Symptoms of the Urinary Tract Infection
The most common symptom of bladder infection i.e lower urinary tract infection is burning while urinating and frequent urge to urinate. These symptoms may last on average of six days an may vary from mild to severe, pain in pelvic bone and lower back are common.
People experiencing infection in the upper respiratory tract also suffer flank pain, nausea and vomiting apart from the symptoms of lower respiratory infection.
Urine may also contain pus and blood in rare cases.
Children: The only probable symptom shown by children is a fever. Because of the lack of other symptoms when children exhibit fever, a sample of urine is suggested to take. Infants usually show symptoms similar to jaundice and might sleep a lot and eat less. In older children, loss of bladder control (incontinence) may occur.
Elderly: the symptoms of urinary tract infection are frequently lacking in the elderly. The only symptoms observed are fatigue, nausea and vomiting. Blood infection can be diagnosed as one of the first symptoms. Diagnosis of the urinary tract can be quite complicated in elderly patients due to preexisting dementia and incontinence.
Causes of Urinary Tract Infection
Uropathetic E-Coli from the gut is the cause of 80-85% of urinary tract infection, with 5-10% infection being caused by staphylococcus saprophyticus. Urinary tract infection due to viral or fungal infection is quite rare. Researchers report the involvement of a much broader range of pathogens including E. coli (27%), Klebsiella (11%), Pseudomonas (11%), the fungal pathogen Candida albicans (9%), and Enterococcus (7%) among others.
Intercourse: Women who are sexually active are more prone to urinary tract infection, the risk of infection is related to the frequency of sex. Sexual activity is 70-90% of the cause of the infection in women. In postmenopausal women, sexual activity doesn’t increase the risk of infection. Use of spermicide, independent of the frequency of sex is the cause of UTI. Use of condoms with spermicide, or birth control pills does not increase the risk of Urinary tract infection in women.
Gender: Women are more susceptible to urinary tract infection as their urethra is much shorter and closer to the anus. After menopause as the estrogen level decreases the protective effect provided by vaginal microflora is lost which makes them vulnerable to the infection. Risk of urinary tract infection in men increases as they age.
Urinary Catheters: The use of urinary catheters is one of the causes of the infection. The risk of bacteria in urine ( Bacteriuria) is about 3-6% in a day and antibiotics don’t mitigate the infection. Male scuba drivers using condom catheters are at higher risk in exhibiting the infection.
Others: predisposition of the lower urinary tract infection ( bladder infection) may run in the families. It is believed to be related to genetics. Other factors include having diabetes or large prostate.
Types of Urinary Tract Infection
Infection can occur in different parts of your urinary tract and the classification is based on the site of infection:
Cystitis: When the site of infection is bladder; one might feel the urge to frequently urinate, it may also hurt when you pass urine. One may experience lower belly pain and cloudy or bloody urine.
Pyelonephritis: When the site of infection is kidney; this starts by pain in your upper back or side followed by fever, chills, nausea, and vomiting.
Urethritis: When the site of infection is urethra; symptoms include a discharge and burning sensation while peeing.
Pathogenesis of Urinary Tract Infection
The bacteria causing infection enters the bladder through the urethra. The bacteria may also cause infection via blood or lymph. Bacteria is usually transmitted to the urethra from bowel, females are at higher risk due to their anatomy. After reaching the bladder, E-coli in urinary tract infection attaches itself to the bladder and forms a biofilm which resists the body’s immune system.
Escherichia coli followed by Klebsiella and Proteus spp are said to be the main cause of urinary tract infection. Quinoline Antibiotic resistance to infection is continuously reported this is because of overuse and misuse of quinoline antibiotic.
Diagnosis of UTI
In most cases, diagnosis can be done and treatment is provided on the basis of symptoms alone without any further laboratory examination. In complicated cases, it is advised to go through urinalysis: looking for the presence of urine nitrites, white blood cells or leukocyte esterase.
Another test includes looking for the presence of red blood cells or white blood cells or bacteria by using urine microscopy.
As symptoms are vague, diagnosis of elderly patients suffering from urinary tract infection is complicated.
Treatment of Urinary Tract Infection
The probably way of treatment is antibiotics. Occasionally prescribed drugs include phenazopyridine for first few days in addition to antibiotics to help with the burning sensation. However, this should not be taken repetitively due to safety concerns; elevated risk of methemoglobinemia. Paracetamol may be used for chills and fevers. Cranberry products are believed to treat the current infection.
Asymptomatic Bacteriuria: Those with bacteria in the urine but show no symptoms shouldn’t generally be treated with antibiotics. This includes people who are old or with urinary catheters. Pregnant women are an exception as UTI in pregnancy is common and are asked to take a dose of 7 days. If the UTI is not treated it increases the risk of low birth weight and preterm birth.
Uncomplicated: Uncomplicated infections can be treated based on symptoms alone. Oral antibiotics are prescribed usually such as cephalosporins and fluoroquinolones. However, the resistance to antibiotics amongst the bacteria that cause urinary tract infection has been increasing.
Pyelonephritis: Kidney disease (infection) is treated more aggressively as compared to other infections. Oral, as well as intravenous antibiotics, are given to the patient, seven days of amoxicillin dose is usually prescribed to the patients.
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