Urinary Tract Infection

A urinary tract infection (UTI) is an infection of the urinary system which comprises of kidneys, bladder and urethra (the tube through which urine exits the body). Sexual encounters are a common cause of this infection in women, however, there are other reasons.  Women are more susceptible to getting this infection than men; children can also get this infection.

While most cases of UTIs do not result in any complications, recurrent UTIs can damage the kidney or be associated with pregnancy complications.  One potentially life-threatening complication is formation of sepsis. Fortunately, there are a number of antibiotics to treated UTIs effectively and preventative measures are sufficient enough to avoid future infections.

What are the Causes?

Women are more prone to getting urinary tract infection.  It occurs when harmful bacteria enter the urethra and spread to the bladder and kidneys. The body’s natural immune system produces antibodies which can deal with these micro-organisms but sometimes they can overwhelm these antibodies and result into a full-blown infection.

Bacteria or other micro-organisms enter usually through the rectal, urethral or vaginal route.  Escherichia coli bacteria is the main culprit responsible for spreading UTIs which is usually found in faeces.  Other bacteria Staphylococcus saprophyticus are found in the vaginal tract.

Risk factors and common causes are,

  • Women are more prone to getting UTIs due to the short distance between the urethra and bladder.
  • Sexually active women are also more prone to getting UTI.
  • Obstruction of flow of urine due to an enlarged prostate or kidney stones can also cause UTIs.
  • Uncircumcised men are more at risk than circumcised men as the bacteria may reside under the foreskin.
  • Long term catheter use also increase the risk of causing infection.
What are the Symptoms?

Symptoms of UTI are pain in the pelvic region, frequent urination with burning, reduced flow and volume and blood in the urine.  Urinary tract infections rarely result in complications.  The rare complication is damage to kidney, urethra and bladder.

Signs and symptoms of UTI are,

  • Frequent urination with reduced flow and volume
  • Burning while urinating
  • Blood and pus in urine
  • Foul-smelling urine
  • Pelvic pain, fever, nausea, and vomiting (if the kidney gets infected).

Fortunately, fever is the only symptom in children. In elderly people, symptoms are rather vague such as fatigue or incontinence.

If UTI does not resolve quickly, it can result in rare but life-threatening complications like chronic kidney infections (pyelonephritis), urethral stricture (narrowing of the male urethra), premature birth or urosepsis which can be life-threatening.

What tests will be required for diagnosis?

Urinalysis is the main diagnostic test to confirm the presence of urinary tract infection, however, one or more other investigations may be done to rule out other reasons for the symptoms.

  • Urinalysis to check for blood, pus, glucose, pus and blood in urine.
  • Urine culture to check which bacteria is causing the infection.
  • Ultrasound, MRI or CT to rule out kidney stones or detect other problems in the urinary tract.
  • Cystoscopy to visualise the bladder for any abnormalities.
Treatment

Antibiotics are the only choice of treatment for urinary tract infection. Urine culture is done to check which micro-organism is causing the infection and accordingly appropriate antibiotic is prescribed.

Antibiotic course usually needs to be taken for three days but can extend for more than a week if the symptoms are severe or the infection is recurrent.  If the kidneys are affected, the duration of the treatment can be longer.  Pregnant women are prescribed a 7-day course of antibiotics to reduce the risk of premature birth even if the symptoms are not present.