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Urinary tract infection

A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. Urinary tract infections have different names, depending on what part of the urinary tract is infected.

• Bladder -- an infection in the bladder is also called cystitis or a bladder infection. Very common for young women, rare for young men.
• Kidneys -- an infection of one or both kidneys is called pyelonephritis or a kidney infection. Serious infectionn requires an antibiotic therapy. It occurs alone or with the epizode of previous cystitis
• Urethra -- an infection of the tube that empties urine from the bladder to the outside is called urethritis. It usually occurs in men. It is often associated with  STD (sexually transmited diseases)

  

Causes

Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the kidneys.

Most of the time, the body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.

Women tend to get UTI more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.

 

Symptoms

The symptoms of a bladder infection include:

• Cloudy or bloody urine, which may have a foul or strong odor
• Low fever (not everyone will have a fever)
• Pain or burning with urination
• Pressure or cramping in the lower abdomen (usually middle) or back
• Strong need to urinate often, even right after the bladder has been emptied

If the infection spreads to your kidneys, symptoms may include:

• Chills and shaking or night sweats
• Fatigue and a general ill feeling
• Fever above 101 degrees Fahrenheit
• Flank (side), back, or groin pain
• Flushed, warm, or reddened skin
• Mental changes or confusion (in the elderly, these symptoms often are the only signs of a UTI)
• Nausea and vomiting
• Severe abdominal pain (sometimes)

 

Exams and Tests

A urine sample is usually collected to perform the following tests:

• Urinalysis is done to look for white blood cells, red blood cells, bacteria, and to test for certain chemicals, such as nitrites in the urine. Most of the time, your doctor or nurse can diagnose an infection using a urinalysis.
• Urine culture - clean catch may be done to identify the bacteria in the urine to make sure the correct antibiotic is being used for treatment.
• CBC and a blood culture may be done.
• Kidney and bladder ultrasound

 

Treatment

Your doctor must first decide whether you have a mild or simple bladder or kidney infection or an infection that is more serious.

 

MILD BLADDER AND KIDNEY INFECTIONS

Antibiotics taken orally are usually recommended because there is a risk that the infection could spread to the kidneys.

• For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 - 14 days (men). For a bladder infection with complications -- such as pregnancy or diabetes, OR a mild kidney infection -- you will usually take antibiotics for 7 - 14 days.
• It is important that you finish all of the antibiotics, even if you feel better. If you do not finish all of your antibiotics, the infection could return and may be harder to treat later.

Commonly used antibiotics include trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline, and fluoroquinolones.

Your doctor may also recommend drugs to relieve the burning pain and urgent need to urinate. Phenazopyridine hydrochloride (Pyridium) is the most common of this type of drug. You will still need to take antibiotics.

Everyone with a bladder or kidney infection should drink plenty of fluids.

 

Some women may have recurrent bladder infections. Your doctor may suggest several different ways how to treat them.

• Taking a single dose of an antibiotic after sexual contact may prevent infections, that occur after sexual activity.
• Having a 3-day course of antibiotics at home to use for infections diagnosed based on your symptoms may work for some women.
• Some women may also try taking a single, daily dose of an antibiotic to prevent infections.

 

Prognosis

A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder infection usually disappear within 24 - 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for your symptoms to go away