UTI is an infection that affects part of the urinary tract.
What's a UTI?
Infection of the urinary tract!
Burning sensation in the urethra, may hbe present even when not urinating, in some cases
Higher UTI's, cause lower UTI Sx in addition to:
Systemic Sx, including fever
Vague or non-specific Sx at the extremities of age
What does it feel like when your urinary tract is infected?
It depends on where the infection is. If it's down lower, there may be pain peeing, a burning like sensation. There may also be changes in peeing, like wanting to go more often, or having the sudden urge to pee. If the infection works it's way up higher, you can get pain higher, up at the groin area. And if the infection works it's way throughout the body, you can get systemic type things, like a fever.
E. coli, mainly, although other bacteria, virus or fungi may rarely be the cause
Female anatomy, because the urethra is much shorter and closer to the anus
Sexual intercourse, particularly anal intercourse
Previous UTI (recurrence is common)
Although sexual intercourse is a risk factor, UTI’s are not classified as STI’s
What causes UTI's?
Any reason why bacteria can get into the urinary tract. E coli is found in the GI tract of healthy people, and because especially in women, where the urethra is so close to the GI outlet, it's a common entrance. Also, the urethra is much shorter in females, as for males it has to travel through the penis, so the distance bacteria has to travel is shorter, so it's quicker. Certain forms of sexual intercourse can introduce bacteria. Family history and previous UTI can contribute ot future likelihood too.
Cystitis, which is infection of the bladder, thereby confined to the lower urinary tract
Pyelonephritis, which is infection of the kidney, thereby affecting the upper urinary tract. It usually follows cystitis, but can also result from bacteremia (i.e. blood-borne infection)
What are the different types of UTI's?
UTI's are classified based on what part of the urinary tract is infected. The higher, the more concerned we are . So the next question is the route of the urinary tract . And that's the urethra, the bladder, the looooong ureter, and then kidneys. Any part can be infected.
What are their names?
Pyelonephritis, which is infection of the kidney. Now you may wonder how does the word "pyelo" relate to the kidneys, and the answer is that "pyelo" means "pelvis", which is where the kidneys are... generally located lol. And "nephr" deriving from the word "nephron", which is the functional unit of the kidney. So that's at the very top, at the kidneys. There's also cystitis, which is infection of the bladder. We prefer that, because it hasn't travelled up the ureter and affected the kidneys.
Dx in young healthy women is based on Sx alone
In those with vague Sx, because bacteria can be present w/o there being an infection
Nitrituria, which is nitrites in urine, as gram negatives (most commonly E coli) make an enzyme, that changes urinary nitrates to nitrites
Leukocyte esterase, which tests for WBC in urine, indicating UTI
Urine culture, in complicated cases, or if Tx has failed (i.e. Sx not improving in 2-3 days after Tx)
How can you check whether someone has an infection of the urinary tract?
You test urine. You might find nitrites, or white blood cells in it. Which isn't normal. Or you can try to culture urine, and see if anything grows in it. You can also work out what antibiotics will work against it by doing that.
Nitrites and white blood cells. Why are these abnormal, and what are they?
Nitrite is something that is created by bacteria, by converting it from a nitrate, which is the waste normally found in urine. White blood cells indicate an infection, which shouldn't normally be found in urine, because urine should be sterile.
Low dose abx, in those w/ frequent infections
Cranberry juice, which may assist with recurrent UTI's
Short course of abx, if uncomplicated, although resistance is increasing. Complicated cases may require a longer course or IV abx. Note that women who have bacterial or WBC in the urine, but have NO symptoms, abx are generally not required, except in pregnant women
Nitrofuran is a class of antibiotics with a furan ring with a nitro group. It includes Nitrofurantoin (NIT, Macrodantin) and Nifurtoinol which are both used in the Tx of UTI's
Trimethoprim, abx used mainly in the Tx of bladder infections. Bactrim is trimethoprim + sulfamethoxazole
Urinary alkalinsers, e.g. Citralite, Citravescent or Ural sachets, help neutralize the acid in the urinary tract, while assit with eliminating organisms that cause infection
Antiseptics, e.g. hiprex
How do you treat a bacterial infection of the urinary tract?
Antibiotics . Of course. You do a short course if there's no biggie, or a long course or IV in complicated cases. We generally use the Nitrofuran class of antibiotics.
What about if we find a patient with NO symptoms, but have bacteria or even WBC's in urine?
We only use it in patients who have symptoms. If they've got no symptoms, we don't use it .
Pyelonephritis, if it occurs, usually follows a bladder infection but may also result from a blood-borne infection
Occur more commonly in women than men, affecting 50% of women at least once in their lives
In women, UTI's are the most common form of bacterial infectino, w/ 10% developing UTI's annually