Urinary Tract Infections -UTI’s are classified as either community acquired or hospital
acquired. The majority of UTI’s are community acquired, usually caused by the bacteria
Escherichia coli (E coli) from the patient's own bowels.
Hospital acquired infections are usually E. Coli, but Pseudomonas and Staphlococci
are important causes, particularly when a surgical instrument such as a catheter
is used; instrumentation is the predisposing factor.
Hospital infections can often be due to multiple organisms, and antibiotic resistance
is a common problem.
It is a serious health problem affecting millions of those each year. Infections
of the urinary tract are the second most common type of infection in the body. Women
are especially prone to UTI’s for reasons that are not yet well understood. One woman
in five develops a UTI during her lifetime. UTI’s in men are not as common as in
women, but can be very serious when they do occur.
You may have a UTI yet experience no symptoms
Urinary tract infections UTI’s - are common in MS those.
Antibiotics remove good bacteria as well as unwanted bacteria.
It is important to check for a UTI if someone is feeling generally unwell or experiences
a worsening of existing symptoms. Treatment of urinary tract infections is a two-stage
process that can be carried out by a GP. Dipstick test to check for urinary tract
infection. Sometimes these may need to be sent to a lab for analysis to determine
the type of bacteria causing the infection.
The NICE Guideline (UK) recommends that anyone experiencing more than three UTI’s
a year should be assessed by a continence specialist.
Cause of UTI’s
Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi but
does contain fluids, salts, and waste products. An infection occurs when tiny organisms,
usually bacteria from the digestive tract, cling to the opening of the urethra and
begin to multiply.
The urethra is the tube that carries urine from the bladder to outside the body.
Most infections arise from one type of bacteria, Escherichia coli (E. coli), which
normally lives in the colon.
In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection
can occur. An infection limited to the urethra is called urethritis. If bacteria
move to the bladder and multiply, a bladder infection, called cystitis, results.
If the infection is not treated promptly, bacteria may then travel further up the
ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis.
Microorganisms called Chlamydia and Mycoplasma may also cause UTI’s in both men and
women, but these infections tend to remain limited to the urethra and reproductive
system. Unlike E.coli, Chlamydia and Mycoplasma may be sexually transmitted, and
infections require treatment of both partners.
Common causes of UTI’s include stagnant urine due to urinary retention or introducing
infection through poor personal hygiene. Catheters
Treatment with appropriate antibiotics
A woman who has frequent recurrences (three or more a year) can ask her health professional
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. 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.
Dipsticks that change colour when an infection is present are now available without
a prescription. The strips detect nitrite, which is formed when bacteria change nitrate
in the urine to nitrite. The test can detect about 90 percent of UTIs when used with
the first morning urine specimen and may be useful for women who have recurrent infections.
Generally tired or washed out feelings most of the time.
Milky or cloudy urine that may smell more strongly than usual.
Painful or burning sensation when urinating.
Painful bladder or abdomen even when not urinating.
Passing a small amount of urine when urinating, even when there is an urge to pass
more.
Symptoms can be confused with other symptoms such as:
Fatigue.
Existing bladder problems.
Untreated UTI’s:
May cause kidney damage
May trigger a relapse.
May worsen spasticity
UTI’s in women.
Women who have had three UTIs are likely to continue having them. Four out of five
such women get another within 18 months of the last UTI. Many women have them even
more often.
Some additional steps that a woman can take on her own to avoid an infection:
Drink plenty of water every day.
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.
UTI’s in men
UTI’s in men are often a result of an obstruction - for example, a urinary stone
or enlarged prostate - or from a medical procedure involving a catheter.
The first step is to identify the infecting organism and the drugs to which it is
sensitive. Usually, health professionals recommend lengthier therapy in men than
in women, in part to prevent infections of the prostate gland.
Prostate infections (chronic bacterial prostatitis) are harder to cure because antibiotics
are unable to penetrate infected prostate tissue effectively. For this reason, men
with prostatitis often need long-term treatment with a carefully selected antibiotic.
UTI’s in older men are frequently associated with acute bacterial prostatitis, which
can have serious consequences if not treated urgently.
Acute prostatitis is a serious bacterial infection of the prostate gland. Men with
this disease often have:
Burning or painful urination.
Body aches.
Chills.
Fever.
Pain in the lower back and genital area.
Urinary frequency and urgency often at night.
A demonstrable infection of the urinary tract, as evidenced by white blood cells
and bacteria in the urine.
Acute prostatitis may be a complication of prostate biopsy.
The Urinary System
The urinary system consists of the kidneys, ureters, bladder, and urethra. The key
elements in the system are the kidneys, a pair of purplish-brown organs located below
the ribs toward the middle of the back. The kidneys remove excess liquid and wastes
from the blood in the form of urine, keep a stable balance of salts and other substances
in the blood, and produce a hormone that aids the formation of red blood cells. Narrow
tubes called ureters carry urine from the kidneys to the bladder, a sack-like organ
in the lower abdomen. Urine is stored in the bladder and emptied through the urethra.
The urinary system is structured in a way that helps ward off infection. The ureters
and bladder normally prevent urine from backing up toward the kidneys, and the flow
of urine from the bladder helps wash bacteria out of the body. In men, the prostate
gland produces secretions that slow bacterial growth. In both sexes, immune defences
also prevent infection, however despite these safeguards, infections still occur.
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.
