Urinary Tract Infections

urinary-tract-infections

Urinary Tract Infections:The urinary tract consists of the kidney, ureters  (which connect the kidneys and the bladder ), bladder, and urethra. Urinary tract infections(UTIs) can occur in any part of the urinary tract. Most UTIs are caused by bacteria. They can also be caused by fungi or viruses.

Causes, incidence, and risk factors:

Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the kidneys.

Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.

Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.

The following also increase your chances of developing a UTI:

  • Diabetes
  • Advanced age (especially people with illnesses common in older adults, such as Alzheimer’s disease  and delirium )
  • Problems emptying your bladder completely (urinary retention)
  • A tube called a urinary catheter   inserted into your urinary tract
  • Bowel incontinence
  • Enlarged prostate, narrowed urethra  or anything that blocks the flow of urine
  • Kidney stones
  • Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture)
  • Pregnancy
  • Surgery or other procedure involving the urinary tract

Symptoms of UTI:

Symptoms of UTI depend upon what part of the urinary tract is infected.

Lower UTIs are infections of the urethra and bladder. Their symptoms include:

  • burning with urination
  • increased frequency of urination with scant amounts of urine being passed
  • bloody urine
  • cloudy urine
  • urine that looks like cola or tea
  • strong odor to urine
  • pelvic pain (women)
  • rectal pain (men)

Upper UTIs are infections of the kidneys. These are potentially life threatening, if bacteria move from the infected kidney into the blood. This condition is called sepsis. Sepsis can cause dangerously low blood pressures, shock  and death. Symptoms of upper UTI include:

  • pain and tenderness in theupper back  and sides
  • chills
  • fever
  • nausea
  • vomiting

Women who are pregnant and have symptoms of UTI should see their doctor right away. UTIs during pregnancy can cause premature delivery and high blood pressure. UTIs during pregnancy are also more likely to spread to the kidneys.

Signs and tests:

A urine sample is usually collected to perform the following tests:

  • Urinalysis  is done to look for white blood cells, red blood cells, bacteria, and to test for certain chemicals, such as nitrites in the urine. Most of the time, your doctor or nurse can diagnose an infection using a urinalysis.
  • Urine culture-clean catch  may be done to identify the bacteria in the urine to make sure the correct antibiotic is being used for treatment.

CBC and a blood culture may be done.

The following tests may be done to help rule out problems in your urinary system that might lead to infection or make a UTI harder to treat:

Pathogenesis: The bacteria  that cause urinary tract infections typically enter the bladder via the urethra. However, infection may also occur via the blood or lymph. It is believed that the bacteria are usually transmitted to the urethra from the bowel, with females at greater risk due to their anatomy. After gaining entry to the bladder, E. Coli are able to attach to the bladder wall and form a biofilm that resists the body’s immune response.

Diagnosis of UTI:

Definitive diagnosis requires a “clean catch” urine specimen. This is urine collected from the middle of the urinary stream. Your doctor will instruct you how to do a clean catch. The goal is to avoid picking up bacteria from your skin.

Doctors will look for a large number of white blood cells in your urine. This can signal an infection. Your urine will also be cultured for bacteria. This can identify the cause of infection. It can also help your doctor choose appropriate treatment.

If an upper UTI is suspected, you may also need a complete blood count (CBC) and blood cultures. These can make certain your infection hasn’t spread to the blood.

People with recurrent UTIs may need to be checked for obstructions. Some tests for this include:

  • ultrasound
  • intravenous pyelogram (IVP) – this injected dye allows doctors to see your entire urinary tract
  • Cystoscopy , which uses a small camera to examine the bladder

During a cystoscopy, your doctor may remove a small piece of bladder tissue. This is called a biopsy. A biopsy can be used to rule out bladder cancer.

Treatment of UTI: Antibiotics are used to treat UTIs. Lower UTIs can be treated with oral antibiotics. Upper UTIs require intravenous antibiotics.

Sometimes, bacteria develop resistance to antibiotics. Urine cultures can help your doctor select an effective antibiotic treatment.

Expectations (prognosis): A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder infection usually disappear within 24 – 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for your symptoms to go away.

Complications:

  • Life-threatening blood infection (sepsis ) – risk is greater among the young, very old adults, and those whose bodies cannot fight infections (for example, due to HIV or cancer chemotherapy)
  • Kidney damage or scarring
  • Kidney infection

The urinary tract consists of the kidneys,ureters   (which connect the kidneys and the bladder), bladder, and urethra. Urinary tract infections (UTIs) can occur in any part of the urinary tract. Most UTIs are caused by bacteria. They can also be caused by fungi or viruses.

Causes, incidence, and risk factors:

Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the kidneys.

Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.

Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.

The following also increase your chances of developing a UTI:

  • Diabetes
  • Advanced age (especially people with illnesses common in older adults, such as Alzheimer’s disease and delirium)
  • Problems emptying your bladder completely (urinary retention)
  • A tube called a urinary catheter   inserted into your urinary tract
  • Bowel incontinence.
  • Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine
  • Kidney stones
  • Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture)
  • Pregnancy
  • Surgery or other procedure involving the urinary tract

Symptoms of UTI:

Symptoms of UTI depend upon what part of the urinary tract is infected.

Lower UTIs are infections of the urethra and bladder. Their symptoms include:

  • burning with urination
  • increased frequency of urination with scant amounts of urine being passed
  • bloody urine
  • cloudy urine
  • urine that looks like cola or tea
  • strong odor to urine
  • pelvic pain (women)
  • rectal pain (men)

Upper UTIs are infections of the kidneys. These are potentially life threatening, if bacteria move from the infected kidney into the blood. This condition is called sepsis. Sepsis can cause dangerously low blood pressures, shock and death. Symptoms of upper UTI include:

  • pain and tenderness in the upper back  and sides
  • chills
  • fever
  • nausea
  • vomiting

Women who are pregnant and have symptoms of UTI should see their doctor right away. UTIs during pregnancy can cause premature delivery and high blood pressure. UTIs during pregnancy are also more likely to spread to the kidneys.

Signs and tests:

A urine sample is usually collected to perform the following tests:

  • Urinalysis  is done to look for white blood cells, red blood cells, bacteria, and to test for certain chemicals, such as nitrites in the urine. Most of the time, your doctor or nurse can diagnose an infection using a urinalysis.
  • Urine culture clean catch  may be done to identify the bacteria in the urine to make sure the correct antibiotic is being used for treatment.

CBC and a blood culture  may be done.

The following tests may be done to help rule out problems in your urinary system that might lead to infection or make a UTI harder to treat:

  • CT scan of the abdomen
  • Intravenous pyelogram  (IVP)
  • Kidney scan
  • Kidney ultrasound

Pathogenesis: The bacteria   that cause urinary tract infections typically enter the bladder via the urethra. However, infection may also occur via the blood or lymph.   It is believed that the bacteria are usually transmitted to the urethra from the bowel, with females at greater risk due to their anatomy. After gaining entry to the bladder, E. Coli are able to attach to the bladder wall and form a bioflim   that resists the body’s immune response.

Diagnosis of UTI:

Definitive diagnosis requires a “clean catch” urine specimen. This is urine collected from the middle of the urinary stream. Your doctor will instruct you how to do a clean catch. The goal is to avoid picking up bacteria from your skin.

Doctors will look for a large number of white blood cells in your urine. This can signal an infection. Your urine will also be cultured for bacteria. This can identify the cause of infection. It can also help your doctor choose appropriate treatment.

If an upper UTI is suspected, you may also need a complete blood count (CBC) and blood cultures.   These can make certain your infection hasn’t spread to the blood.

People with recurrent UTIs may need to be checked for obstructions. Some tests for this include:

  • ultrasound
  • intravenous pyelogram (IVP) – this injected dye allows doctors to see your entire urinary tract
  • Cystosocopy,  which uses a small camera to examine the bladder

During a cystoscopy, your doctor may remove a small piece of bladder tissue.  This is called a biopsy. A biopsy can be used to rule out bladder cancer.

Treatment of UTI: Antibiotics are used to treat UTIs. Lower UTIs can be treated with oral antibiotics. Upper UTIs require intravenous antibiotics.

Sometimes, bacteria develop resistance to antibiotics. Urine cultures can help your doctor select an effective antibiotic treatment.

Expectations (prognosis): A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder infection usually disappear within 24 – 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for your symptoms to go away.

Complications:

  • Life-threatening blood infection (sepsis) – risk is greater among the young, very old adults, and those whose bodies cannot fight infections (for example, due to HIV or cancer chemotherapy)
  • Kidney damage or scarring
  • Kidney infection

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