What is urinary tract?
The urinary tract is the system responsible for producing, storing, and removing urine out from the body. It consists of:
- Kidneys: Filtering blood to remove waste products and produce urine.
- Ureters: one ureter connected to each kidney and urine flows from the kidneys into the ureters downward towards the bladder.
- Bladder: It is a hollow, muscular organ serves as a reservoir for storing urine.
- Urethra: A tube that carries urine from the bladder to the outside of the body. the length of the urethra is longer in males then females.
What is Urinary Tract Infection (UTI)?
It's an infection that causes inflammation in lining of any part of the urinary system, including the kidneys, bladder, ureters, and urethra. Symptoms may include:
- A frequent urge to urinate,
- Pain or burning sensation during urination,
- Cloudy or strong-smelling urine,
- Pelvic pain in women,
- In severe cases, UTIs can lead to complications such as kidney infection (pyelonephritis) or bloodstream infection (sepsis).
What causes UTI?
Bacterial Infection
Urinary tract
infections (UTIs) are commonly caused by bacteria. The most common (in 90% of
cases) bacterial culprit responsible for UTIs is Escherichia coli (E.
coli). Other bacteria such as Klebsiella, Enterococcus, Proteus,
and Staphylococcus saprophyticus can also cause UTIs, although less
frequently.
E. coli, Klebsiella,
Enterococcus species are commonly found in the human colon and
around the anus and hence can be easily transferred through wash jet
spray from anus to urethra in females (due to their anatomy) and through
dirty hands. These bacteria including Proteus species can also be
present in the environment, such as in soil and contaminated water.
These infection causing bacteria can be acquired through contact with
contaminated medical equipment or surfaces.
Staphylococcus
saprophyticus bacterium is commonly found on the skin hence is more frequently associated with UTIs in young sexually active women.
Bacteria in urine sample under the microscope and urine culture
Fungal
(Yeast) Infection
The most common
fungal species that can cause UTIs include the yeast Candida species,
particularly Candida albicans.
Fungal UTIs are more commonly seen in individuals with:
Low immunity, such as those with diabetes, immunosuppressive treatments, HIV/AIDS, or those undergoing chemotherapy.
Antibiotic use, the vagina has some good bacteria (Lactobacilli) to maintain the acidic pH which prevents the growth of infection causing bacteria and yeast. Use of antibiotics (for any other infection in the body) can kill the good bacteria and disrupt the balance of microorganisms in the body, leading to overgrowth and the development of yeast infections.
Pregnancy may cause hormonal changes and alterations in the vaginal environment which may leads to yeast infections.
- Shorter urethra of Women than men, making it easier for bacteria to reach the bladder.
- Sexual intercourse can introduce bacteria into the urinary tract of females
- Kidney stones obstruct the flow of urine can increase the risk of UTIs.
- Catheters, which are tubes inserted into the bladder of patients to drain urine, can introduce bacteria into the urinary tract.
- Weak immune system due to certain Conditions or Medications that can make individuals more susceptible to infections
Diagnosis of UTI
- Physical
examination: The healthcare provider will assess the patient's symptoms (frequent
urination, urgency, burning or pain during urination), medical history(use of antibiotics or other medicines), and risk factors for UTIs (immune status, sexual activities, stones etc.)
- Urinalysis: A urine sample
is collected and microscopically analyzed for the presence of white blood
cells, red blood cells, and presence of bacterial or fungal elements.
- Urine culture: A urine sample
may be cultured to identify the specific fungal or bacterial species causing
the infection.
How to prevent UTI?
- Drinking plenty of
water helps flush bacteria and toxins out of the urinary tract.
- Practice good
hygiene
habits, including wiping from front to back after using the toilet to prevent
bacteria from entering the urethra.
- Don't hold
urine for
long periods, as this can allow bacteria to multiply in the bladder.
- Urinate and
wash sexual
organs before and after sexual activity to help flush out bacteria from the
urinary tract or use condoms.
- Females should
avoid using harsh soaps, douches, or feminine hygiene sprays inside the vagina
as they can disrupt the natural pH balance and increase the risk of UTIs.
- Patients with diabetes
or urinary tract abnormalities (kidney stones etc.), should manage these
conditions effectively, as they are more prone to UTIs.
- If you need a urinary catheter, follow proper catheter care
procedures to reduce the risk of UTIs.
Treatment of UTI
The treatment involves
use of antibiotics (antibacterial or antifungal) to eliminate the bacterial or
fungal infection causing the symptoms. The choice of antibiotic depends
on type of bacteria/fungus identified and duration of treatment depends
on the severity of symptoms.
The healthcare
provider decide antibiotic based upon medical history of the patient. Hence,
medicines should not be taken without consultation.
Commonly prescribed antibiotics for bacterial UTIs include:
- trimethoprim-sulfamethoxazole,
- nitrofurantoin
- ciprofloxacin.
For fungal UTIs, antifungal medications such as:
- fluconazole or
- amphotericin-B may be prescribed.
Unnecessary and
irregular use of antibiotics may cause antibiotic resistance which can be
dangerous.
Uncomplicated UTIs are treated with a short course of antibiotics, ranging from 3 to 7 days. Complicated UTIs or recurrent infections may require longer courses of treatment. Failure to complete the treatment regimen can lead to recurrence of the infections or development of antibiotic resistance.
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