Urinary Tract Infection (UTI)
Urinary tract infection (UTI) is second to respiratory infection as the most common type of infection in the body. It is a bacterial infection involving the kidneys, ureters, bladder, or urethra. These are the structures that urine passes through before being eliminated from the body.
The upper urinary tract is composed of the kidneys and ureters, and the lower urinary tract consists of the bladder and the urethra.
Types
When an infection affects the lower urinary tract (urethra or bladder), it may be called Urethritis or Cystitis if it only affects the bladder. If it migrates to the upper urinary tract (ureters or kidneys), it is called Ureteritis, and if it affects just the kidneys, it is known as Pyelonephritis.
Urinary tract infections are much more common in adults than in children, but about 1%–2% of children also experience UTIs. UTIs in children (besides bedwetting) are more likely to be serious and should not be ignored, especially in younger age groups.
Causes of UTIs
More than 90% of UTI cases are caused by a type of bacteria called Escherichia coli (E. coli). These bacteria normally live in the bowel and around the anus. E. coli is harmless in the bowel but thrives rapidly when introduced into urine’s acidic environment.
UTIs usually occur when E. coli bacteria enter the urine and begin to grow. The infection often starts at the opening of the urethra and moves upward into the urinary tract to the bladder. If untreated, it can quickly spread to the kidneys.
Normally, urination flushes bacteria out through the urethra. However, when bacteria multiply excessively, urination may not stop their spread.
Risk Factors for UTIs
Anything that reduces bladder emptying or irritates the urinary tract can cause UTIs.
Obstructions: Blockages that make it difficult to empty the bladder — such as enlarged prostate, kidney stones, or certain cancers — can lead to UTIs.
Sexual Activity: Pressure on the urinary tract during sex can push bacteria from the colon into the bladder. Although the body usually clears them within 24 hours, some bacteria can stick to the bladder lining.
Bathroom Hygiene: Wiping from back to front after using the toilet can drag bacteria from the rectal area toward the urethra.
Spermicides: Spermicides may irritate the skin, increasing the chance of bacteria entering the bladder.
Condoms: Latex condoms may cause friction and irritation, increasing the risk of UTIs in some individuals. However, they remain essential for preventing STIs.
Diaphragms: Diaphragms can put pressure on the urethra, decreasing bladder emptying and raising UTI risk.
Weakened Immune System: Conditions like diabetes and HIV, as well as medications used after organ transplantation, can reduce immunity and increase the risk of kidney infections.
UTI Symptoms
UTIs do not always cause symptoms, but when present, they may include:
- A strong, persistent urge to urinate
- A burning sensation while urinating
- Passing frequent, small amounts of urine
- Cloudy urine
- Red, bright pink, or cola-colored urine (blood in urine)
- Strong-smelling urine
- Pelvic pain (in women)
Treatments and Drugs for UTI
Antibiotics are generally used for treating UTIs. The specific antibiotic and treatment duration depend on the patient’s health condition and the type of bacteria found in the urine.
Simple Infection:
Commonly recommended medications include:
- Sulfamethoxazole-trimethoprim
- Amoxicillin
- Ampicillin
- Ciprofloxacin
Symptoms usually improve within a few days, but antibiotics may be required for a week or more to completely eradicate the infection. Some uncomplicated UTIs can be treated with a short course of antibiotics lasting one to three days, depending on symptoms and medical history.
Frequent Infections:
For recurring UTIs, recommended treatments may include:
- Longer antibiotic courses
- Short-course therapy at the start of symptoms
- A single antibiotic dose after sexual intercourse (if UTIs are related to sex)
- Vaginal estrogen therapy for postmenopausal women to reduce recurrence
Severe Infection:
In severe cases, hospitalization may be required for intravenous antibiotics.