URINARY TRACT INFECTION

 

 

 

URINARY TRACT INFECTION

Urinary Tract Infection (UTI)  is an infection in any part of your urinary system which includes your kidneys, ureters, bladder and urethra. The infection is usually involve the lower tracts. It can involve one or both kidneys, one or both ureters.

Urinary tract infections typically occur when groups of microorganisms like bacteria gain access into the urinary tract through the urethra and begin to reproduce and multiply in the bladder. Naturally, the body system through the immune system is designed to fight out such microorganisms but there may be failed defense immune at times which gives bacteria freedom to hold and grow into full blown infection of the urinary tract. Urinary tract infection usually affect the bladder and urethra

 

EPIDEMIOLOGY
It’s commoner in women than men
Women usually have repeated occurrence

Causes
Urine is naturally sterile but get infected often due to bacteria from your own bowel flora which include Escherichia coli, Coliforms, Staphylococcus epidermidis, Proteus, Klebsiella aerogenes, Enterococcus faecalis or by Viruses like polyoma virus , CMV, adenovirus and so on. Some of the causes include:.
• Infection of the bladder (cystitis). This is caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract.
• Sexual intercourse : it may lead to cystitis, but you don’t have to be sexually active to develop it. Women are at risk of cystitis because of their urethra has short short distance to the anus and to the urethral opening. Unprotected sex is also a leading cause as one may get infected from someone who already has It is.
• Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.

 

CLASSIFICATION:
1. UPPER OR LOWER UTI; Upper Urinary tract infections include pyelonephritis while Lower urinary tract infections include urethritis, cystitis and prostatitis.
2. COMPLICATED OR UNCOMPLICATED UTI: Complicated UTI are the urinary tract infections seen in men, pregnant women and children While Uncomplicated UTI refers to acute pyelonephritis or cystitis in non- pregnant outpatient women without any instrumentation or anatomical abnormalities of the urinary tract.

 

Symptoms
Urinary tract infections signs and symptoms include;
• Urinary urgency
• A burning sensation when urinating
• Passing frequent, small amounts of urine
• Urine that appears cloudy and frothy
• Hematuria (bloody urine)
• Dysuria (painful urine)
• High fever
• Chills and rigor
• Pyuria (pus in urine)
• Nocturia
• Nausea and vomiting
• Straining Urine
• Dribbling urine
• Suprapubic or flank pain
• Scrotal swelling
• Coca-Cola Urine
• Foul-smelling urine
• Rectal pain men
• Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone.

 

Clinical Investigation
• Full blood count to check for anemia and leukocytosis
• Electrolyte, urea and creatinine test, to rule out complications
• Blood culture
• Urine Microscopy; gold standard for culture and sensitivity

 

RISK FACTORS
Urinary tract infections are common in women, and many women experience more than one infection during their lifetimes. Risk factors specific to women for UTIs include:
• Female anatomy. A woman has a shorter urethra than a man and thus shortens the distance covered by bacteria to travel in reaching the bladder.
• Sexual Intercourse. Sexually active women tend to have more UTIs than do women who aren’t sexually active. Multiple sexual partner also increases your risk.
• Certain types of birth control. Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents.
• Menopause. After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.
• Urinary tract abnormalities. Urinary tract abnormalities like fistula and bladder diverticulum don’t allow urine to pass out normally and cause reflux of urine.
• Urinary tract obstruction. Kidney stones and enlarged prostate can trap urine in the bladder and increase the risk of UTIs.
• Immunosuppression :. Diseases like diabetes in women often impair the immune system— thus, increase the risk of UTIs.
• Indwelling catheter use: People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of infections.
• Spinal injury
• Use of Spermicides
• Douching
• Washing from back to front

 

Complications
Complications of a UTI may include:
• Recurrent infections leading to pyelonephritis.
• Permanent kidney damage due to an untreated UTI.
• Increased risk of delivery of low birth weight or premature babies.
• Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
• Sepsis
• Reinfection and Relapse

 

TREATMENT
The best line of treatment is antibiotic therapy for 3-5 days.

 

Prevention
• Drink plenty of WATER.: Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
• Drink cranberry juice. Although not yet clinically proves but studies shows that cranberry juice prevents UTIs, and it’s not harmful.
• Wipe from front to back. Wiping front to back after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and the urethra. This is better compare to wiping back to front.
• Empty your bladder soon after intercourse. Immediately after sex, drink a glass of water and urinate ,this helps to flush out bacteria.
• Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth and should be avoided.