Urinary Tract Infection in Adults-9 Best Preventive Measures

Urinary tract infection is a very common infection especially in females than males which includes organs of the urinary tract. This article discusses urinary tract infection, the rationale of infection, risk factors, causes, and treatment methods.

Urinary Tract Infection is simply defined as infections of the organs of our urinary tract which include the kidney, ureter, urethra, and bladder. Most people suffer from lower urinary tract infections which include bladder and urethra. The infection of the urethra is called urethritis, the bladder is called cystitis, and the kidney is called pyelonephritis.

UTI is more common in women than men due to anatomical reasons. Infection, when get limited to the bladder, will be painful and irritating. However when it involves your kidney then can give serious complications

Anatomy of Urinary Tract

  • Kidney: It is a bean-shaped organ that filters waste and water from our body later converting to urine.
  • Ureter: These are the tube-like structures that carry urine from the kidneys to the urinary bladder.
  • Urinary Bladder: It is a bag-like structure that stores urine before leaving the body.
  • Urethra: It is a tube-like structure that carries urine from the bladder outside the body.
Urinary Tract infection
Fig1: Urinary Tract Anatomy

Rationale of UTI

Urinary tract infections are quite prevalent, affecting one out of every five women at some point in their lives. UTIs are more frequent in women, although they can also affect men, the elderly, and children. Urinary tract infections affect one to two percent of young children. Urinary tract infections account for 8 million to 10 million doctor visits each year.

Causes of UTI

Bacteria enter the urinary tract through the urethra and multiply in the bladder, resulting in urinary tract infections. Despite the fact that the urinary system is designed to keep such small invaders out, these defenses do not always work. Bacteria may take root and grow into a full-blown infection in the urinary tract if this happens.

The bladder and urethra are the most prevalent sites for UTIs in women. Urinary tract infection (cystitis). Escherichia coli (E. coli), a kind of bacteria typically found in the gastrointestinal (GI) tract, is the most prevalent cause of this form of UTI. Other bacteria, on the other hand, are sometimes to blame.

Cystitis can be caused by sexual activity, but you don’t have to be sexually active to get it. Because of the short distance between the urethra and the anus, and the urethral entrance to the bladder, all women are at risk of cystitis.

Urinary tract infection (urethritis). When GI bacteria travel from the anus to the urethra, this form of UTI develops. Sexually transmitted illnesses like herpes, gonorrhea, chlamydia and mycoplasma can also induce urethritis since the female urethra is so close to the vagina.

Risk Factors of UTI

For women

  • Anatomy of the urinary tract in females: Women have a shorter urethra than men which helps bacteria to reach the bladder much faster.
  • Sexual activity: Sexually active women have chances to develop UTI.
  • Birth control measures: Diaphragms using females for preventing conception are at higher risk.
  • Menopause: After menopause, estrogen level decreases which make changes in the urinary tract  making females more vulnerable to infection

Other Risk Factors

  • Deformities in Urinary Tract: Babies who have deformities in the urinary tract causing urine to back up in the urethra are at high risk for Urinary tract infection.
  • Urine tract Blockage: Stones in the kidney or prostate enlargement could cause trapping of urine in the bladder causing a high risk for UTI.
  • Use of catheters: People who use catheters are at high risk of UTI.
  • Impairment in the immunity system: Medicines that cause suppression of the immune system like diabetes make people prone to higher risk.

Routes of Infection

UTI  develops either by ascending route or descending route.

Ascending Route

In this route bacteria first, get attached to urethral epithelial mucosal cells and then reaches the bladder either because of instruments or due to the access of fecal flora colonizing in the urethra. 

Descending Route

This route of infection is very rare. This takes place due to the hematogenous spread of bacteria from the primary source which lies in some part of our body.

The most commonly found organism causing UTI  found to be Escherichia coli, which takes over 85% accountability of total cases. The organism for the remaining 15% is Staphylococcus saprophyticus and Klebsiella and Proteus species.

Symptoms

Symptoms of UTI
                                                Fig3:  Symptoms of UTI

 

Urine Tract Infection causes the urinary tract layer to become swollen or inflamed and red due to which people suffering from UTI present some symptoms like:

  • Flank Pain in abdomen or pelvic
  • Urgency in urination
  • Increase in frequency of urination
  • Painful urination and blood in Urine
  • Cloudy urine and foul smell
  • Urinary incontinence(leakage of urine)
  • Burning Sensation in lower back or belly
  • Pain during sex
  • Pain in penis
  • Fatigue
  • Fever
  • Vomiting

Bladder Infection in Pregnant Woman

UTI is common in women but when it is of pregnant condition then it could be alarming because this may lead to preterm birth and low birth weight.

Causes of Urine Tract Infection in Pregnancy

In pregnant women, the uterus grows larger for the growing fetus. Due to this, it causes pressure on the bladder therefore all the urine may not be out from the bladder. And that leftover urine could be the source of infection.

In pregnancy, there are hormonal changes that cause changes in the urinary tract. This variation in the urinary tract results in vesicourethral reflux. In Vesicourretral reflux, the urine flows back up from the bladder to kidneys and therefore resulting in UTI.

The other reason for the high risk of UTI in a pregnant woman is urine consist of a high amount of sugar, protein, and hormones making it a suitable medium for the growth of microorganisms thus increasing the chances of Urinary Tract Infection.

E .coli the most common bacteria for causing UTI is normal intestinal flora. It can move from rectum to urethra if wiping is not done from front to back.

There is another group of bacteria called Group B streptococcus which is normally present in the colon and vagina of many women. This can cause UTI and it can also be transmitted to the newborn baby. For this, a test should be done around 36-37 weeks. If there are positive results then during labor antibiotics are prescribed by a doctor.

Diagnosis

Laboratory Diagnosis of UTI
Fig4: Laboratory Diagnosis of UTI

Urine Analysis

This test is a common test for UTI diagnosis. Here the presence of red blood cells and pus cells indicates the presence or absence of infection. In short, we can say that a urine routine examination can work as a preliminary diagnosis for urine infection.

But there are some chances of contamination so it is better to instruct the patient to wipe the genitalia with an antiseptic pad and collect the midstream urine.

Urine Culture

Urine culture shows the type of bacteria which is responsible for urine infection. Though it takes 48 hours for a complete diagnosis, this test helps clinicians to prescribe antibiotics based on an antibiotic sensitivity test.

If the treatment is not showing positive results or in the cases of recurrent UTI the following test may help

  • Ultrasound: It is a painless method that actually depends on forming the image of internal organs.
  • Cystoscopy: A instrument consisting of a lens is used to see inside the bladder and urethra.omplications of UTI.

Complications of UTI 

If diagnosed and treated earlier UTI does not cause any serious results. But when left without any medication can lead to serious consequences. Some of the complications are listed below.

  • Recurrent infections may occur.
  • An untreated UTI may lead to permanent renal damage from an acute or chronic kidney infection(Pyelonephritis)
  • Like in gonococcal urethritis narrowing of urethra or stricture can be seen in men due to recurrent urethritis.
  • An untreated UTI spreads from the kidney to the blood causing septicemia, shock, and then death.

Complications of UTI in pregnancy

In the case of pregnancy, kidneys can be severely infected. Other complications include

  • Preterm labor
  • Severe infection
  • Adult respiratory distress syndrome
  • Anemia
  • Long-term infection
  • hypertension
  • Preeclampsia
  • Thrombocytopenia

Treatment Of Urinary Tract Infection in Adults and Pregnant women

Generally, the antibiotic is prescribed based on the antibiotic sensitivity pattern on urine culture. There are some common antibioticsamoxicillinerythromycin, and penicillin which are safe for women during pregnancy.

Prevention of Urinary Tract Infection 

Plenty of water consumption:

 Drinking 8 glasses of water in a day could prevent UTI.

 Personal Hygiene:

 Since the urethra of women is shorter than in females one should always be careful in maintaining personal hygiene. Genitals should be washed, preferably from front to back after bowel infection to prevent bacteria from entering inside the urinary tract. Further good hygiene practices should be made during the menstrual cycle.

 Urination Habits:

 Urinating frequently could also help in preventing UTI. Urinating before and after sex helps in prevention too. Urine is a waste product of the body and therefore urinating whenever it feels helps to wash out all the impurities and decrease the risk of getting UTI.

 Birth control Measures:

 Women who use a diaphragm as a birth control measure have a higher risk to develop UTI.

Probiotics

The use of probiotics could also help prevent UTIs.

Food and Supplements

Consuming foods rich in Vitamin C and Vitamin D or taking their supplements helps in preventing UTIs. Food rich in vitamin C makes urine acidic which helps in killing infectious bacteria.

Heating pad

A heating pad could be really helpful in providing relief during the pain and pressure in the pelvic region which is due to UTI

 Cranberry Juice

Many studies have shown that cranberry juices are helpful in urine infection as it makes your urine more acidic thus creating an unfavorable condition for bacterial growth.

Prevention/Treatment  Of Recurrent UTI and menopause

The doctor may prescribe a low dose of antibiotics for about 6 months in case of recurrent UTI. Consumption of a single dose of antibiotic after having sex could be one of the remedies for recurrent UTI.

In case of menopause estrogen vaginal cream is recommended. In menopause, there will be very little amount estrogen which results in vaginal dryness and thus keeps the urinary tract at risk of UTI. The vaginal cream maintains the PH of the area making a suitable environment for good bacteria to grow.

Simple management techniques with lifestyle changes

Some nutritionists say that imbalance in hormones could also be one of the reasons for the increased risk of UTI. However, there is a high possibility that it could be fixed with some changes in daily life habits. The following are some suggestions that can help you prevent UTIs

  • Handwashing before and after using the washroom.
  • It is better to use clean underwear made of breathable fabric
  • It is better not to hold pee as it can result in pressure in the bladder resulting in UTI. 
  • Allow urine to pass normally. Don’t push it.
  • Generally, urine is a sterile fluid but it could be an excellent medium for bacterial growth if kept for a longer period of time. Therefore attend the nature’s call as soon as possible.
  • While doing a workout it is better to choose the fabric wisely that does not cause dampness around the vaginal region
  • It is better to take a bath after the completion of the workout routine.
  • An adequate amount of sleep is very important because many hormones are regulated while sleeping.

Which specialist is best for urinary tract infection?

Ans- It is better to visit a urologist. Though other physicians can also prescribe medicines for urinary tract infection patients it is best to visit a urologist for recurrent infections

Why is UTI more common in females than in males?

Females have a shorter urethra than males which allows bacteria to travel a shorter distance to reach the bladder and cause the UTI.

Does urine consist of organisms?

Urine is a sterile fluid but when hold for a longer period of time it could be a suitable medium for bacteria to grow.

Do urine infections affect urine color?

Yes UTI may cause urine to have a strong odor, cloudy in appearance, and sometimes it is blood mixed.

What sample is best for diagnosing UTI?

Midstream urine is best for diagnosing urine infections.

What are the general symptoms of UTI?

The most common symptoms include polyuria with burning sensation with cloudy urine and sometimes cola-colored.

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