Urinary tract infections are a serious health problem affecting millions of people each year.
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Second Month of Pregnancy
signs and symptoms of urinary tract infection
Infections of the urinary tract are common -- only respiratory infections occur more often. Each year,
urinary tract infections (UTI's) account for about 8 million doctor visits. Women are especially prone
to UTI's for reasons that are poorly understood. One woman in five develops a UTI during her
male urinary tract infection symptoms
The urinary system consists of the kidneys, ureters, bladder, and urethra. The key players in the
system are the kidneys, a pair of purplish-brown organs located below the ribs toward the middle of
of salts and other substances in the blood, and produce a hormone that aids the formation of red
feline urinary tract infection symptomsNarrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped
chamber in the lower abdomen. Urine is stored in the bladder and emptied through the urethra.
The average adult passes about a quart and a half of urine each day. The amount of urine varies,
depending on the fluids and foods a person consumes. The volume formed at night is about half that
formed in the daytime.
Causes
the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria,
Escherichia coli (E. coli), which normally live in the colon.
in the urethra. An infection limited to the urethra is called urethritis. From there bacteria often move on
to the bladder, causing a bladder infection (cystitis). male urinary tract infection symptomsIf the infection is not treated promptly, bacteria
may then go up the ureters to infect the kidneys (pyelonephritis).
Unlike E.
Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both
partners. The urinary system is structured in a way that helps ward off infection. The ureters and
bladder helps wash bacteria out of the body. In men, the prostate gland produces secretions that slow
bacterial growth. In both sexes, immune defenses also prevent infection. Despite these safeguards,
though, infections still occur.
Who is at Risk
Any abnormality of the urinary tract that
obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. An enlarged
prostate gland also can slow the flow of urine,urine tract infection symptoms thus raising the risk of infection.
infection is catheters, or tubes, placed in the bladder.
Some people,
catheter for life.
keep the catheter sterile and remove it as soon as possible.
People with diabetes have a higher risk of a UTI because of changes of the immune system. Any
UTI's may occur in
with surgery. UTI's are rarely seen in boys and young men. In women, though, the rate of
UTI's gradually increases with age.
than men. One factor may be that a woman's urethra is short, allowing bacteria quick access to the
bladder. Also, a woman's urethral opening is near sources of bacteria from the anus and vagina. For
many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are
unclear. According to several studies, women who use a diaphragm are more likely to develop a UTI
than women who use other forms of birth control. Recently, researchers found that women whose
partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the
vagina.
Many women suffer from frequent UTI's. Nearly 20 percent of women who have a UTI will have
Of the last group, 80 percent will have
recurrences. Usually, the latest infection stems from a strain or type of bacteria that is different from
the infection before it, indicating a separate infection.
coli, slight differences in the bacteria indicate distinct infections.)
UTI's may be the ability of bacteria to attach to cells lining the urinary tract. A recent NIH funded
study has also shown that women with recurrent UTI's tend to have certain blood types. Some
lining the vagina and urethra may allow bacteria to attach more easily. Further research will show
whether this association is sound and proves useful in identifying women at high risk for UTI's.
Infections in Pregnancy
Pregnant women seem no more prone to UTI's than other women. However, when a UTI does occur,
it is more likely to travel to the kidneys. According to some reports, about 2 to 4 percent of pregnant
women develop a urinary infection. Scientists think that hormonal changes and shifts in the position of
the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For
this reason, many doctors recommend periodic testing of urine.
Symptoms
Not everyone with a UTI has symptoms, but most people get at least some.
frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during
urination. It is not unusual to feel bad all over-tired, shaky, washed out -- and to feel pain even when
not urinating.
It is common for a person with a urinary infection to complain that,
The urine itself may look milky or
A fever may mean that the infection has reached the kidneys.
Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or
In children, symptoms of a urinary infection may be overlooked or attributed to another
A UTI should be considered when a child or infant seems irritable, is not eating normally,
there is a change in the child's urinary pattern.
Diagnosis
To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria. You
will be asked to give a "clean catch" urine sample by washing the genital area and collecting a
(This method of collecting urine helps prevent
bacteria around the genital area from getting into the sample and confusing the test results.) Usually,
the sample is sent to a laboratory, although some doctors' offices are equipped to do the testing.
In the urinalysis test, the urine is examined for cat urinary tract infection symptomswhite and red blood cells and bacteria. Then the
bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys
the bacteria. This last step is called a sensitivity test.
A doctor suspects one of these infections when a person has symptoms of a UTI and pus in the urine,
but a standard culture fails to grow any bacteria.
When an infection does not clear up with treatment and is traced to the same strain of bacteria, the
doctor will order a test that makes images of the urinary tract.
pyelogram (IVP), which gives x-ray images of the bladder, kidneys, and ureters. An opaque dye
visible on x-ray film is injected into a vein, and a series of x-rays are taken. The film shows an outline
of the urinary tract, revealing even small changes in the structure of the tract.
If you have recurrent infections, your doctor also may recommend an ultrasound exam, which gives
pictures from the echo patterns of soundwaves bounced back from internal organs.
test is cystoscopy.
light source, which allows the doctor to see inside the bladder from the urethra.
Treatment
UTI's are treated with antibacterial drugs.
The sensitivity test is especially
uncomplicated UTI's are trimethoprim (Trimpex), trimethoprim/sufamethoxazole (Bactrim, Septra,
Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and
ampicillin. Often, a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated
by an obstruction or nervous system disorder. Still, many doctors ask their patients to take antibiotics
for a week or two to assure that the infection has been cured. Single-dose treatment is not
signs of a kidney infection, patients with diabetes or structural abnormalities, or men who have
prostate infections. Longer treatment is also needed by patients with infections caused by
Mycoplasma or Chlamydia, which are usually treated with tetracycline, trimethoprim/sulfamethoxazole
(TMP/SMZ), or doxycycline. A follow-up urinalysis helps to confirm that the urinary tract is
infection-free. It is important to take the full course of
Severely ill patients with kidney infections may be hospitalized until they can take fluids and needed
Kidney infections generally require several weeks of antibiotic treatment.
effective as 6 weeks of treatment with the same drug in women with kidney infections that did not
involve an obstruction or nervous system disorder. In such cases, kidney infections rarely lead to
Various drugs are available to relieve the pain of a UTI. A heating pad or a warm bath may also help.
Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. For the
(And one of the best things a smoker
can do for his or her bladder is to quit smoking. Smoking is the major known cause of bladder
cancer.)
Recurrent Infections in Women
About 4 out of 5 women who have a UTI get another in 18 months.
more often.
about one of the following treatment options:
Take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. (If
taken at bedtime, the drug remains in the bladder longer and may be more effective.)
NIH-supported research at the University of Washington has shown this therapy to be effective
without causing serious side effects.
Take a single dose of an antibiotic after sexual intercourse.
Take a short course (1 or 2 days) of antibiotics when symptoms appear.
The
The test can
detect about 90 percent of UTI's and may be useful for women who have recurrent infections.
Drink plenty of water every day.
Vitamin C (Ascorbic Acid)
Urinate when you feel the need; don't resist the urge to urinate;
Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra;
Take showers instead of tub baths;
Cleanse the genital area before sexual intercourse;
Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
baby and other risks such as high blood pressure. Some antibiotics are not safe to take during
effectiveness, the stage of pregnancy, the mother's health, and potential effects on the fetus.
Complicated Infections
Curing infections that stem from a urinary obstruction or nervous system disorder depends on finding
If the root cause goes untreated, this
group of patients is at risk of kidney damage.
UTI's are unusual in men. They usually stem from an obstruction -- for example, a urinary stone or
enlarged prostate -- or a medical procedure involving a catheter. The first step is to identify the
male urinary tract infection symptomsUsually, doctors recommended lengthier
therapy in men than in women, in part to prevent infections of the prostate gland. Prostate infections
(prostatitis) are harder to cure because antibiotics are unable to penetrate infected prostate tissue
effectively.
selected antibiotic.
The NIH conducts and supports a variety of research in diseases of the kidney and urinary tract.
knowledge gained from these studies is advancing scientific understanding of why UTI's develop and
is leading to improved methods of diagnosing, treating, and preventing infections.
Information provided by the NIH & NIDDK
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