Common Urinary Tract Infections (UTI) & Ways to Prevent it

Urinary tract infection (UTI) is a common infection causing various symptoms related to passage of urine. It is more common in women but can affect anyone at any age. Let us understand some of the common urinary tract infections and how to prevent them.

Urinary tract infection may be asymptomatic (subclinical infection) or symptomatic (disease). Thus the term urinary tract infection encompasses a variety of clinical entities including asymptomatic bacteriuria (ASB), cystitis, prostatic, and pyelonephritis. The term urinary tract infection denotes symptomatic disease; symptomatic infection of the bladder; and pyelonephritis, asymptomatic infection of the kidneys. Uncomplicated common urinary tract infections refers to acute cystitis or pyelonephritis in non-pregnant outpatient women without anatomic abnormalities or instrumentation of the urinary tract; the term complicated urinary tract infection encompasses all other types of urinary tract infections.

Urinary tract infection (UTI) occurs far more commonly in women than in men due to the short ureter. In new born babies or neonatal period, urinary tract infections may be more common in male infants due to their high risk of congenital urinary tract anomalies. After 50 years of age, obstruction from prostatic hypertrophy is common in men, thus increasing the risk of urinary tract infection in elderly men.

Urinary tract infection (UTI) can be lower urinary tract infections which include urethra and bladder or upper urinary tract infection which include ureters and kidney.

1. Cystitis

   Cystitis is an infection of the bladder, one of the common Urinary tract infection (UTI). The typical symptoms of cystitis are dysuria, urinary frequency and urgent nocturia, hesitancy, suprapubic discomfort and gross hematuria. Pain in the back or flank on the affected side usually indicates upper urinary tract involvement. Fever also is a common sign that indicates infection of either the kidney or the prostate.

2. Pyelonephritis & Its Symptoms

   It refers to infection of kidneys due to ascending of the bacteria and is yet another common urinary tract infections (UTI). Mild pyelonephritis can present as low-grade fever with or without low back pain, whereas severe pyelonephritis can manifest as high fever, rigor, nausea, vomiting, and flank and/or loin pain. Symptoms are generally acute in onset, and most common urinary tract infections are accompanied with fever.

   Patients with diabetes may present with obstructive uropathy associated with acute papillary necrosis when the sloughed papillae obstruct the ureter. Papillary necrosis may also be evident in some cases of pyelonephritis complicated by obstruction, sickle cell disease, analgesic nephropathy, or combinations of these conditions.

   In the rare case of bilateral papillary necrosis may occur and a rapid rise in the serum creatinine level may be the first indication. Emphysematous pyelonephritis is a particularly severe form of the disease that is associated with the production of gas in the tissues of kidney and surrounding area. Such complication of common urinary tract infections is usually seen in diabetic patients. Xanthogranulomatous pyelonephritis occurs when the chronic urinary obstruction (often by staghorn calculi), together with chronic infection, leads to a suppurative destruction of renal tissue.

   If there is continued fever there is a risk of bacteremia, which may need immediate medical treatment.

3. Complicated UTI

   It usually refers to many episodes of cystitis and pyelonephritis in otherwise healthy non-pregnant person. Complicated Urinary tract infection (UTI) presents as the asymptomatic episode of cystitis or pyelonephritis in a man or woman with an anatomic predisposition infection, with a foreign body in the urinary tract, or with factors predisposing to the delayed response to therapy.

4. Urethritis

   Urethritis refers to inflammation of urethra which carries urine from the bladder to the external of the body. It can be caused due to bacterial infection from the skin around urethral opening. E.coli, gonococcus or Chlamydia trachomatis commonly cause urethritis. This too is a common Urinary tract infection (UTI).

   The patient usually presents with pain during urination, increase frequency or urgency of micturition and sometimes difficulty in starting urination. Other symptoms may include pain during sexual intercourse, discharge from urethral opening or blood in semen in the case of men.

5. Catheter Acquired Urinary Tract Infections

   This is one of the most common Urinary tract infection (UTI) and is known as CAUTI. Most of such infections are endogenous that is patient’s own colonic flora causes them. The indwelling catheter offers conduit services to bacterial entry along external and internal routes. Biofilms have been demonstrated on catheters being used for a prolonged time can induce urinary tract infections. The formation of a biofilm layer of living uropathogenic organism on the urinary catheter causes these types of urinary infections and affects both therapeutic and preventive strategies. Organisms in a biofilm are relatively resistant to killing by an antibiotic, and eradication of a catheter-associated biofilm is difficult without removal of the device itself. Furthermore, because catheters provide a channel for bacteria to enter the bladder, bacteriuria is often seen with long-term catheter use.

Here are some effective ways to prevent common urinary tract infection (UTI):

1. General Measures To Prevent UTI

   You can take these steps to reduce your risk of urinary tract infections:

   • Drink Plenty of Liquids, Especially Water – This is the most widely popular way to prevent urinary tract infections. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
   • Wipe from Front to Back – By doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra. This too is very important to prevent urinary tract infections.
   • Empty Your Bladder Soon After Intercourse – It is necessary to maintain hygiene after intercourse and keep the area clean. Also drinking a full glass of water to help flush bacteria and prevent urinary tract infections.
   • Avoid Potentially Irritating Feminine Products – Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra. Avoid such chemicals to prevent urinary tract infections in addition to skin infections and allergies.
   • Change Your Birth Control Method – Diaphragms, or lubricated or spermicide-treated condoms, can all contribute to bacterial growth.
   • Pass Urine More Often – A stagnate fluid is an ideal environment for an infection to develop. You should use the bathroom at least once every 4 to 6 hours, and more often (about every 3 hours) if you’re prone to UTIs. Passing urine more regularly is a healthy way to prevent urinary tract infections.

2. Don’t Douche

   Douching sends a stream of water, or water mixed with antiseptics like vinegar, into your vagina to wash out bad-smelling vaginal bacteria. It can also washes out good bacteria, disrupting the natural balance in your vagina and allowing more bad bacteria to grow.

   Take Cranberry Supplements – Cranberries contain proanthocyanidins, which are thought to prevent bacteria from sticking to the bladder and help to prevent urinary tract infections.

   Wear Breathable Underwear – Tight fabric can create a moist area that breeds bacteria, so you should probably opt for cotton under wears that leave some breathing space.

   Eat Probiotics – Fermented drinks like kombucha and probiotic-heavy yogurts like kefir might help more than your digestion. Preliminary studies say taking probiotic supplements or eating probiotic foods can help produce healthy bacteria.

   Change Out of Sweaty Workout Clothes and Wet Swimsuits – If you have frequent urinary tract infections it won’t hurt to quickly change into dry clothes, which will reduce the risk of and prevent urinary tract infections.

3. Specific Measures To Prevent Urinary Tract Infection

   These methods to prevent urinary tract infections include treatment with specific medication to prevent further advancement of infection. The treatment is specific for each and includes: –

   Fluoroquinolones is the first line therapy for acute uncomplicated pyelonephritis. Similarly, urinary tract infections in pregnant women and men with prostate problems must be treated at once to prevent further complications.

   For complicated urinary tract infections (UTIs), percutaneous drainage can be used as the initial therapy in emphysematous pyelonephritis and can be followed by elective nephrectomy as needed. The best strategy to prevent urinary tract infections due to catheter use is to avoid the use of catheter however mild catheterization can be done with necessary precautions in some cases.

   Overall, Urinary tract infections (UTIs) are very common type of infections that can be prevented by taking appropriate hygiene measures mentioned above.