Urinary tract infection

 

Urinary tract infection

  Introduction

A urinary tract infection (UTI) is an infection in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary tract— specifically the bladder (cystitis) and the urethra (urethritis). UTIs are common, especially in women, and are typically caused by bacteria like E. coli entering the urethra.

 

 Causative Agents

The primary causative agent for Urinary tract infection (UTIs) is bacteria, most commanly Escherichia coli (E.coli),and other bacteria  like Klebsella pneumonae, proteus miralibis and Enterococcus. Common fungi involved in UTI Include Candida albicans.Organism involved in UTIs  generally originates from the gut and enter the urinary tract.

    Escherichia coli (E.coli) is the most common which originates from gut and accounts for 75-95% of cases world wide.

                                               

                                        Figure: E.Coli

 

Symptoms

1. Lower UTI: Lower abdominal pain, Cloudy/blood in urine, sudden urge to urinate etc.

                        2. Upper UTI :High body temperature (above 100.4°F, Chills, Confusion, Pain in back

 .Diagnosis

·    Urine analysis: A "clean-catch" midstream urine sample is collected in sterile container and tested for white blood cells (leukocytes), red blood cells (hematuria), and nitrites (produced by certain bacteria like E.coli ) and urine culture.

 

 

 

                                          Figure: RBC/WBC count by Microscopy

·    Urine Culture: 

Urine culture is considered as gold standard test that specifies type of bacteia involved in infection and also which antibiotic are most effective through Antibiotic sensitive testing.

                                 Figure: organism from urine on culture media

                                  Figure: Antibiotic sensitivity test of organism 

 Treatment

1. Simple (Uncomplicated) UTIs: Typically affect healthy, non-pregnant women. Common medications include:

Ø Nitrofurantoin: Often prescribed for 5 days.

Ø Trimethoprim-sulfamethoxazole: Commonly taken for 3 days.

Ø Fosfomycin : A single-dose powder mixed with water.

Ø Cephalexin or Cefdinir: Often used for 5 to 7 days.

 

2. Complicated or Severe Infections: If the infection spreads to the kidneys (pyelonephritis) or occurs in men or pregnant women, longer courses or different medications is required.

Ø Fluoroquinolones (Ciprofloxacin, Levofloxacin): Reserved for complicated cases or when other options are unsuitable due to the risk of serious side effects.

Ø Intravenous (IV) Antibiotics: Required in case of severe infections that cause vomiting, high fever, or sepsis, often requiring a hospital stay.

 Home Care and Lifestyle

1.  Hydration: Drink plenty of water (at least 6–8 glasses daily) to help flush bacteria out of the urinary tract.    
2. Bladder Habits: Empty your bladder fully and urinate as soon as you feel the urge.
3. Personal Care: Assistance with daily living activities such as bathing, grooming, dressing, and mobility.