Organs Of The Urinary Tract
The urinary tract consists of the kidneys, ureters , bladder, and urethra. These organs may be injured by blunt force or by penetrating force . Injuries may also occur unintentionally during surgery.
UTIs are usually classified as upper or lower according to where they occur along the urinary tract, although it is sometimes difficult or impossible for doctors to make such a determination:
Some doctors also consider infections of the urethra and prostate to be lower UTIs. In paired organs , infection can occur in one or both organs. UTIs can occur in children Urinary Tract Infection in Children A urinary tract infection is a bacterial infection of the urinary bladder , the kidneys , or both. Urinary tract infections are caused by bacteria. Infants and younger… read more as well as in adults.
Can A Urinary Tract Infection Be Prevented
Many methods have been suggested to reduce or prevent UTIs. The single most important prevention measure is increased fluid intake. Many people develop UTIs simply because they do not drink enough fluids.
Incomplete bladder emptying and resisting the normal urge to urinate can allow pathogens to survive and replicate easier in a non-flowing system. Some clinicians recommend washing before and urinating soon after sex to reduce the chance of urethritis and cystitis.
Many clinicians suggest that anything that causes a person irritation in the genital area may encourage UTI development. Wearing underwear that is somewhat adsorptive may help wick away urine drops that otherwise may be areas for pathogen growth.
Nonculture Methods For The Laboratory Diagnosis Of Uti
Detection of bacteriuria by urine microscopy. Bacteriuria can be detected microscopically using Gram staining of uncentrifuged urine specimens, Gram staining of centrifuged specimens, or direct observation of bacteria in urine specimens. Gram stain of uncentrifuged urine specimens is a simple method. A volume of urine is applied to a glass microscope slide, allowed to air dry, stained with Gram stain, and examined microscopically. The performance characteristics of the test are not well-defined, because different criteria have been used to define a positive test result. In one study, the test was found to be sensitive for the detection of 105 cfu/mL but insensitive for the detection of lower numbers of bacteria . Other investigators have found the test to be of low sensitivity for the detection of UTI .
Performance characteristics of Gram staining for detection of bacteriuria.
Performance characteristics of leukocyte esterase and nitrite tests, alone or in combination, for detection of bacteriuria and/or pyuria.
A number of drugs can change the color of urine abnormal urine color may affect urine tests that are based on the interpretation of color changes. In some cases, this can mask color changes, and in others, it may result in false-positive interpretations .
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Overview Of Urinary Tract Infections
, MD, University of Riverside School of Medicine
In healthy people, urine in the bladder is sterileno bacteria or other infectious organisms are present. The tube that carries urine from the bladder out of the body contains no bacteria or too few to cause an infection. However, any part of the urinary tract can become infected. An infection anywhere along the urinary tract is called a urinary tract infection .
What Are The Symptoms Of A Urinary Tract Infection
These are the most common symptoms of a UTI:
- Frequent urination
- Pain or burning when passing urine
- Urine looks dark, cloudy, or reddish in color
- Urine smells bad
- Feeling pain even when not urinating
- Pain in the back or side, below the ribs
- Nausea and/or vomiting
- Despite an strong urge to urinate, only a small amount of urine is passed
- Women may feel an uncomfortable pressure above the pubic bone
The symptoms of UTI may look like other conditions or medical problems. Always see a health care provider for a diagnosis.
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How To Feel Better
If your healthcare professional prescribes you antibiotics:
- Take antibiotics exactly as your healthcare professional tells you.
- Do not share your antibiotics with others.
- Do not save antibiotics for later. Talk to your healthcare professional about safely discarding leftover antibiotics.
Drink plenty of water or other fluids. Your healthcare professional might also recommend medicine to help lessen the pain or discomfort. Talk with your healthcare professional if you have any questions about your antibiotics.
Urinary Tract Infection Caused By Group B Streptococcus
Group B Streptococcus is a Gram-positive chain-forming bacterium that commonly dwells in the lower gut and female reproductive tract without causing any symptoms. Statistics show that the bug causes only about 12% of all UTIs.
Advanced age and pregnancy are the main risk factors for contracting a UTI caused by this organism. In fact, GBS UTIs can be fatal in the elderly population. Those with poor immunitysuch as in those suffering from cancer and diabetes, and pre-existing abnormalities of the urinary tract such as chronic kidney disease or stones in the kidneysare subject to additional risk factors for contracting a GBS UTI.
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Causes Of Recurrent Utis
Women who experience two or more UTIs in a six-month period, or those who have three or more UTIs in the course of a year are diagnosed with recurrent UTIs.
Sexual intercourse is a common cause of UTIs in women. People who use catheters are also at increased risk of developing recurrent UTIs.
After experiencing six or more UTIs a year, Marie knew there was a bigger problem. Learn how she finally found an answer at CU Urogynecology.
Read Her Success Story
How Are Utis Diagnosed
Only a health care provider can treat urinary tract infections. The first thing a doctor will do is confirm that a person has a UTI by taking a clean-catch urine specimen. At the doctor’s office, you’ll be asked to clean your genital area with disposable wipes and then pee into a sterile cup.
The sample may be used for a urinalysis or a urine culture . Knowing what bacteria are causing the infection can help your doctor choose the best treatment.
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How Do Utis Affect Pregnancy
Changes in hormone levels during pregnancy raise your risk for UTIs. UTIs during pregnancy are more likely to spread to the kidneys.
If you’re pregnant and have symptoms of a UTI, see your doctor or nurse right away. Your doctor will give you an antibiotic that is safe to take during pregnancy.
If left untreated, UTIs could lead to kidney infections and problems during pregnancy, including:
- Premature birth
- Low birth weight
What Are The Treatment Options For Uti
Urine alkalizer and antibiotics are the first choices for treating urinary tract infections .
The physician chooses antibiotics to treat your UTI based on:
- Effectiveness of the antibiotic toward infecting bacteria.
- The severity of the infection.
- Your age group.
- Antibiotic resistance.
Some of the antibiotics used to treat UTIs include:
- Beta-lactams, including penicillins and cephalosporins many organisms have shown resistance to some of these drugs
- Trimethoprim–sulfamethoxazole combination antibiotic many organisms may show resistance to this type of antibiotic
- Fluoroquinolones avoid giving them to pregnant women or the pediatric population
- Tetracyclines are used for Mycoplasma or Chlamydia infections never use them to treat pregnant women or the pediatric population
- Aminoglycosides are usually used in combination with other antibiotics to treat severe UTIs
- Macrolides are used more often to treat some urinary problems caused by sexually transmitted diseases
- Fosfomycin , a synthetic phosphonic acid derivative, is used for acute cystitis but not in complicated UTIs
Apart from antibiotics, cranberry juice is known to show improvement in UTIs however, monitor for the following signs if you are drinking cranberry juice to treat UTIs:
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Vaccines Targeting Bacterial Toxins And Proteases
The UPEC pore-forming toxin HlyA has also received attention as a potential vaccine target and was evaluated in a mouse model of pyelonephritis to assess protection against renal damage114,115. Vaccination with HlyA reduced the incidence of renal scaring compared with controls however, it did not protect against UPEC colonization of the kidneys115. In addition, in a mouse model of UTI, vaccination with the P. mirabilis haemolysin, HpmA, did not provide protection against bacterial colonization116. However, vaccination with Pta, an alkaline protease with toxic effects towards epithelial cells, displayed promising results in a mouse model of UTI, protecting against upper UTI, although bacterial burdens in the bladder remained unaffected116. Thus, although haemolysins and proteases might provide effective vaccine targets for preventing upper UTIs, additional studies are needed to determine the effectiveness of these enzymes as targets for vaccines.
You Dont Drink Enough Water
Guzzling H2O will make you go pretty often. And thats a good thing. When you do this, the bacteria gets flushed out before they have a chance to grab hold, Minkin says.
Consider that your cue to make a giant water bottle your BFF. Hooton TM, et al. . Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: A randomized clinical trial. DOI: 10.1001/jamainternmed.2018.4204
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What Are Possible Complications Of A Urinary Tract Infection
Most UTIs cause no complications if they spontaneously resolve quickly or if treated early in the infection with appropriate medications. However, there are a number of complications that can occur if the UTI becomes chronic or rapidly advances.
- Chronic infections may result in urinary strictures, abscesses, fistulas, kidney stones, and, rarely, kidney damage or bladder cancer.
- The rapid advancement of UTIs can lead to dehydration, kidney failure, sepsis, and death.
- Pregnant females with untreated UTIs may develop premature delivery and low birth weight for the infant and run the risk of rapid advancement of the infection.
Living With Urinary Tract Infections
If you have 3 or more urinary tract infections each year, your doctor may want you to begin a preventive antibiotic program. A small dose of an antibiotic taken every day helps to reduce the number of infections. If sexual intercourse seems to cause infections for you, your doctor many suggest taking the antibiotic after intercourse.
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What Is A Urinary Tract Infection
A urinary tract infection is an infection of the urinary system. This type of infection can involve your urethra , kidneys or bladder, .
Your urine typically doesnt contain bacteria . Urine is a byproduct of our filtration systemthe kidneys. When waste products and excess water is removed from your blood by the kidneys, urine is created. Normally, urine moves through your urinary system without any contamination. However, bacteria can get into the urinary system from outside of the body, causing problems like infection and inflammation. This is a urinary tract infection .
What Causes Strep Infection In Your Urinary Tract
Group B strep are bacteria that can live in your bladder and sometimes cause a urinary tract infection . And, if youre pregnant, they can threaten the life of your unborn baby.
The problem is that group B strep can spread to a newborn infant during delivery, causing life-threatening infections, including pneumonia and meningitis.
Thats why doctors test pregnant women for group B strep between 35 and 37 weeks of pregnancy. If you test positive for the bacterium, it means that theres a chance you could pass it on to your baby during labor and delivery.
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When Should I Call The Doctor
As soon as you think that your child has a UTI, call your doctor. The doctor may recommend another urine test after treatment to be sure that the infection has cleared.
If your child has from recurrent UTIs, consult a pediatric urologist, who can do a thorough evaluation and order tests for urinary system abnormalities. In the meantime, follow your doctors instructions for treating a UTI.
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Urinary Tract Infection In Adults
According to the most recently available combined data from the Centers for Disease Control and Prevention’s annual National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, in 2007 there were 8.6 million ambulatory visits for UTI in both men and women in the United States.123 Pyelonephritis is far less common than cystitis, comprising approximately 250,000 cases per year in the United States.77
May Loo MD, in, 2009
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Reasons Why You Might Get Recurring Utis
Many women who get a urinary tract infection may get one again at some point in their lives. In fact, one in five women experience recurrent UTIsan infection that occurs two times or more within six months or at least three times in a year. Men can get recurrent UTIs too, but it is not as common and is often due to some type of urinary tract blockage.
What Are The Symptoms Of A Uti
If you have a UTI, you may have some or all of these symptoms:6,7
- Pain or burning when urinating
- An urge to urinate often, but not much comes out when you go
- Pressure in your lower abdomen
- Urine that smells bad or looks milky or cloudy
- Blood in the urine. This is more common in younger women. If you see blood in your urine, tell a doctor or nurse right away.
- Feeling tired, shaky, confused, or weak. This is more common in older women.
- Having a fever, which may mean the infection has reached your kidneys
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Vaccines Targeting Bacterial Adhesion
As adherence has a key role at nearly every step of UTI pathogenesis, one attractive strategy for the development of antivirulence therapies, including vaccines, has been to target CUP pili. As a general rule, vaccination with whole pili has been ineffective at generating an antibody response that can protect against UTIs. However, adhesin-based vaccines have been shown to be effective at blocking hostpathogen interactions, thus preventing the establishment of disease108112. Experiments using mouse and cynomolgus monkey models of UTIs determined that immunization with PapDPapG or FimCFimH chaperoneadhesin complexes protected against UTIs108112. The effectiveness of the FimCFimH vaccine was shown to be due, in large part, to antibodies that block the function of FimH in bladder colonization110. Furthermore, the anti-FimH antibodies did not seem to alter the E. coli niche in the gut microbiota109. Modifications of this vaccine are currently under development, with the aim of inducing greater immune stimulation108,112. For example, one approach has been to fuse FimH to the flagellin FliC in order to induce a more substantial acute inflammatory response, which functions through TLR4 signalling via the MYD88 pathway112. A Phase I clinical trial began in January 2014 to evaluate the efficacy of a FimCFimH vaccine using a synthetic analogue of monophosphoryl lipid A as the adjuvant.
Latin America: Progress Towards Regional Guidelines
Close to one-tenth of the worlds population lives in Latin America. Theunique ethnic makeup of patients, alongside local variation in the availabilityof medicines, antibiotic resistance, and health care practices necessitates thecreation of regional guidelines on the treatment of UTI. Prescription ofantibiotics for recurrent UTI without consideration of preventive measures iscommon in many Latin American countries. In a global survey of E.coli susceptibility in 10 countries, the mean sensitivity totrimethoprim/sulfamethoxazole was 71.2% in the sole representative LatinAmerican country, Brazil, it was 54.4%.46
The current Brazilian guidelines were based on systematic review and expertopinion, organized by the Urogynecology Committee of the Brazilian Federation ofGynecology and Obstetrics Associations . Thecommittee included papers that cover genital prolapse, stress urinaryincontinence, overactive bladder, mixed urinary incontinence, painful bladdersyndrome, and recurrent UTI. Guideline sections covering genital prolapse andstress urinary incontinence have been published in the Brazilian Journal ofGynecology and Obstetrics.47,48 The guidelines forrecurrent UTI have yet to be published in a peer-reviewed journal, but areavailable online as a guide for members of FEBRASGO they recommend behavioralmodification, followed by immunomodulatory prophylaxis ,and, finally, by either continuous or postcoital antimicrobial prophylaxis.
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Causes Of Recurrent Urinary Tract Infections
The most common recurrent urinary tract infection causes in women are
- The female urethra is shorter than a mans, which means that bacteria has a shorter distance it needs to travel in order to get to the bladder, multiply, and cause infection.
- The proximity of the female urethra and rectum can result in a bacteria exchange from the rectum to the urethra, particularly if the patient wipes back to front instead of front to back after defecating.
They can be prevented by:
- Staying hydrated aka drinking plenty of water, ideally a gallon per day, to flush out bacteria.
- Being cautious when using a diaphragm during sex. Diaphragms can push up against the urethra, which makes it harder to fully empty the bladder during urination. The urine that doesnt empty is more likely to grow bacteria.
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Is It Possible To Prevent Recurrent Urinary Tract Infections With A Vaccine
Currently, there are no commercially available vaccines for UTIs, either recurrent or first-time infections. One of the problems in developing a vaccine is that so many different organisms can cause infection a single vaccine would be difficult to synthesize to cover them all. Even with E. coli causing about most infections, the subtle changes in antigenic structures that vary from strain to strain further complicate vaccine development even for E. coli. Researchers are still investigating ways to overcome the problems in UTI vaccine development.
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