Patients Care

UTI

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. The main causative agent is Escherichia coli. Although urine contains a variety of fluids, salts and waste products, it usually does not have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they cause a UTI. The most common type of UTI is a bladder infection.

A urinary tract infection is an infection involving the kidneys, ureters, bladder, or urethra. These are the structures that urine passes through before being eliminated from the body.

Causes

  • An infection occurs when bacteria get into the urine and begin to grow. The infection usually starts at the opening of the urethra and moves upward into the urinary tract.
  • These bacteria can move from the area around the anus to the opening of the urethra. The two most common causes of this are poor hygiene and sexual intercourse.
  • Usually, the act of emptying the bladder (urinating) flushes the bacteria out of the urethra. If there are too many bacteria, urinating may not stop their spread.
  • If they reach the kidney, they can cause a kidney infection , which can become a very serious condition if not treated promptly.
  • People with conditions that block the urinary tract, such as kidney stones.
  • People with medical conditions that cause incomplete bladder emptying.
  • People with suppressed immune systems: Examples of situations in which the immune system is suppressed are AIDS and diabetes.
  • Sexual intercourse can introduce larger numbers of bacteria into the bladder. Infection is more likely common in women who have frequent intercourse.
  • Women who use a diaphragm for birth control.
  • Men with an enlarged prostate: Prostatitis or obstruction of the urethra by an enlarged prostate can lead to incomplete bladder emptying, thus increasing the risk of infection. This is most common in older men.
  • Males are also less likely to develop UTIs because their urethra (tube from the bladder) is longer. There is a drier environment where a man's urethra meets the outside world and fluid produced in the prostate can fight bacteria.

Sign and symptoms

  • Lower urinary tract infection (cystitis): The lining of the urethra and bladder becomes inflamed and irritated.
  • Pain or burning during urination.
  • Frequency: more frequent urination (or waking up at night to urinate); often with only a small amount of urine.
  • Urgency: the sensation of not being able to hold urine.
  • Hesitancy: the sensation of not being able to urinate easily or completely (or feeling that you have to urinate but only a few drops of urine come out).
  • Cloudy, bad-smelling, or bloody urine.
  • Lower abdominal pain.
  • Mild fever (less than 101o F), chills and "just not feeling well" (malaise).
  • Upper urinary tract infection Symptoms develop rapidly and may or may not include the symptoms for a lower urinary tract infection.
  • Fairly high fever (higher than 101o F).
  • Shaking chills
  • Nausea
  • Vomiting
  • Flank pain
  • In newborns, infants, children and elderly people, the classic symptoms of a urinary tract infection may not be present. Other symptoms may indicate a urinary tract infection.
  • Elderly people: fever or hypothermia, poor appetite, lethargy, change in mental status.
  • Pregnant women are at increased risk for an UTI. Typically, pregnant women do not have unusual or unique symptoms. If you are pregnant, your urine should be checked during prenatal visits because an unrecognized infection can cause pregnancy complications or miscarriage.

Newborns, Infants and Children

  • Newborns: fever or hypothermia (low temperature), poor feeding, jaundice.
  • Infants: vomiting, diarrhea, fever, poor feeding, not thriving
  • Children: irritability, eating poorly, unexplained fever that doesn't go away, loss of bowel control, loose bowels, change in urination pattern.

Management

  • A patient with dysuria (painful voiding) and urinary frequency generally has a spot mid-stream urine sample sent for urinalysis.
  • The diagnosis of UTI is confirmed by a urine culture.
  • Antibiotics (medications that kill bacteria) are the usual treatment for bladder infections and other urinary tract infections. Seven to ten of antibiotics are usually required, although some infections may require only a single dose of antibiotics.
  • An additional urine test may be ordered about a week after completing treatment to be sure the infection is cured.