Urinary Tract Infections: An Overview

What is Urinary Tract Infection?

Urinary Tract Infections (UTIs) are bacterial infections known to affect either the upper (pyelonephritis) or lower (urethritis, cystitis and prostitis) urinary tract. Presence of significant amount of bacteria (>105 organisms/mL) must be established before diagnosis is made, though symptomatic infections had been identified by new studies in patients with only 103 organisms/mL amount of bacteria. The most common causative agent of UTI is Escherichia coli (causes 85% of community-acquired infection), but other bacteria coming from the normal flora of the host may also be a pathogen.

Who are likely to get infected?urinary tract infections

Among people between 1 and 65 years of age, UTI predominantly occurs in female patients presumably attributed to the anatomy of female urethra which renders bacteria a much easier access to the urinary tract. Other known predisposing factors to UTI include recent sexual intercourse, wearing of tight-fitting underwear or clothing, spermicide and diaphragm usage for contraception, pregnancy, estrogen deficiency, antecedent antibiotic use and incomplete bladder emptying secondary to neurologic pathology such as stroke and spinal cord injury.

What are the common symptoms of UTI?

 The most common symptoms reported by patients include persistent urinary urgency, painful or difficulty in urination (dysuria), presence of blood in the urine, and cloudy and malodorous urine. Other known features of UTI are urinary frequency, suprapubic discomfort, fever, flank or abdominal pain and urinary incontinence.

What will be done if I’m infected?

Actions to be taken depend on the severity of the infection, but both stable and severely ill patients must initiate empirical antibiotic therapy even before results of the culture are obtained and this should be based on their symptoms and urinalysis. The urine sample for culture and sensitivity test, however, must be taken first before start of antibiotic treatment. The initial antibiotic to be administered depends on the patient’s history (e.g. allergies, frequent infection, other drugs recently taken) and the prevalence of resistant organism in the community. Later adjustment to the treatment can be done once result of the culture is obtained. For those who present with high fever and chills, hospital admission and immediate intravenous antibiotic treatment may be needed.

If the patient presents with recurrent or persistent urinary tract infection despite administration of appropriate therapy, further tests must be performed, with possible referral to urologist, to determine if the infection is secondary to structural or functional abnormality.

How can I protect myself from getting infected?

UTI can be very well prevented by implementing some lifestyle modifications, particularly those that pertain to modifiable risk factors such as diet, voiding practices and sexual behavior. The following are some advises that may provide protection against UTI:

  1. All patients should be advised to have adequate intake of fluid every day (6-8 glasses) to ensure the urge to void every 3-4 hours

  2. One should empty the bladder completely when voiding and must avoid putting off the urge to urinate, especially after coitus.

  3. The appropriate way to wash the female genitalia is to wipe from front to back and not the otherwise. This is to prevent bacteria that may come from the anus to the urethra. Also, douching must be avoided.

  4. During menstruation, frequent changing of sanitary napkin is advised.

  5. Tobacco and alcohol consumptions are advised to be avoided since both have a direct irritative effect to the kidney and the bladder. Caffeine and chocolate may also worsen the symptoms of those with infection since they are also known as irritant to the bladder.

  6. Intake of cranberry juice is suggested to be helpful in UTI prevention.

  7. Urinating before and after sexual intercourse may help prevent UTI.

  8. Number of sexual partners is suggested to be limited.

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