Urinary tract infections are a serious health problem affecting millions of people each year.
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Infections of the urinary tract are common -- only respiratory infections occur more often. Each year,
Women are especially prone
to UTI's for reasons that are poorly understood. One woman in five develops a UTI during her
signs and symptoms of urinary tract infection
The Urinary Tract
The urinary system consists of the kidneys, ureters, bladder, and urethra. The key players 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 liquid waste 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. urinary tract infection symptoms womenNarrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped
Urine is stored in the bladder and emptied through the urethra.
The average adult passes about a quart and a half of urine each day. The amount of urine varies,
The volume formed at night is about half that
formed in the daytime.
Causes
It contains fluids, salts, and waste products, but it is free of bacteria, viruses,
and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to
the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria,
coli), which normally live in the colon. In most cases, bacteria first begin growing
in the urethra. An infection limited to the urethra is called urethritis. From there bacteria often move on
to the bladder, causing a bladder infection (cystitis).
may then go up the ureters to infect the kidneys (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.
Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both
partners. 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 both sexes, immune defenses also prevent infection.
though, infections still occur.
Some people are more prone to getting a UTI than others.
obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. An enlarged
prostate gland also can slow the flow of urine,urinary tract infection symptoms thus raising the risk of infection. A common source of
infection is catheters, or tubes, placed in the bladder. A person who cannot void, is unconscious or
especially the elderly or those with nervous system disorders who lose bladder control, may need a
catheter for life. Bacteria on the catheter can infect the bladder, so hospital staff take special care to
keep the catheter sterile and remove it as soon as possible.
People with diabetes have a higher risk of a UTI because of changes of the immune system.
disorder that suppresses the immune system raises the risk of a urinary infection. UTI's may occur in
infants who are born with abnormalities of the urinary tract, which sometimes need to be corrected
with surgery. UTI's are rarely seen in boys and young men.
UTI's gradually increases with age. Scientists are not sure why women have more urinary infections
One factor may be that a woman's urethra is short, allowing bacteria quick access to the
bladder.
unclear. According to several studies, women who use a diaphragm are more likely to develop a UTI
than women who use other forms of birth control.
coli bacteria in the
vagina.
Recurrent Infections
Many women suffer from frequent UTI's. Nearly 20 percent of women who have a UTI will have
another, and 30 percent of those will have yet another. Of the last group, 80 percent will have
recurrences. Usually, the latest infection stems from a strain or type of bacteria that is different from
(Even when several UTI's in a row are due to E.
coli, slight differences in the bacteria indicate distinct infections.)
Research funded by the National Institutes of Health (NIH) suggests that one factor behind recurrent
UTI's may be the ability of bacteria to attach to cells lining the urinary tract. A recent NIH funded
study has also shown that women with recurrent UTI's tend to have certain blood types. Some
scientists speculate that women with these blood types are more prone to UTI's because the cells
Further research will show
whether this association is sound and proves useful in identifying women at high risk for UTI's.
Infections in Pregnancy
Pregnant women seem no more prone to UTI's than other women. However, when a UTI does occur,
it is more likely to travel to the kidneys.
women develop a urinary infection.
the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For
this reason, many doctors recommend periodic testing of urine.
Symptoms
Not everyone with a UTI has symptoms, but most people get at least some. These may include a
frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during
not urinating. Often, women feel an uncomfortable urinary tract infection symptomspressure above the pubic bone, and some men
experience a fullness in the rectum. It is common for a person with a urinary infection to complain that,
despite the urge to urinate, only a small amount of urine is passed. The urine itself may look milky or
cloudy, even reddish if blood is present.
Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or
vomiting.
disorder. A UTI should be considered when a child or infant seems irritable, is not eating normally,
has an unexplained fever that does not go away, has incontinence or loose bowels, or is not thriving.
The child should be seen by a doctor if there are any questions about these symptoms, especially if
You
(This method of collecting urine helps prevent
bacteria around the genital area from getting into the sample and confusing the test results.) Usually,
In the urinalysis test, the urine is examined for male urinary tract infection symptomswhite and red blood cells and bacteria.
bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys
the bacteria. This last step is called a sensitivity test.
but a standard culture fails to grow any bacteria.
When an infection does not clear up with treatment and is traced to the same strain of bacteria, the
doctor will order a test that makes images of the urinary tract. One of these tests is an intravenous
pyelogram (IVP), which gives x-ray images of the bladder, kidneys, and ureters.
The film shows an outline
of the urinary tract, revealing even small changes in the structure of the tract.
If you have recurrent infections, your doctor also may recommend an ultrasound exam, which gives
test is cystoscopy.
patient's history and the urine tests that identify the offending bacteria. The sensitivity test is especially
useful in helping the doctor select the most effective drug.
uncomplicated UTI's are trimethoprim (Trimpex), trimethoprim/sufamethoxazole (Bactrim, Septra,
Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and
ampicillin. Often, a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated
by an obstruction or nervous system disorder. Still, many doctors ask their patients to take antibiotics
for a week or two to assure that the infection has been cured. Single-dose treatment is not
recommended for some groups of patients, for example, those who have delayed treatment or have
Longer treatment is also needed by patients with infections caused by
Mycoplasma or Chlamydia, which are usually treated with tetracycline, trimethoprim/sulfamethoxazole
(TMP/SMZ), or doxycycline.
infection-free.
treatment because symptoms may disappear before the infection is fully cleared.
drugs on their own. Kidney infections generally require several weeks of antibiotic treatment.
Researchers at the University of Washington found that 2-week therapy with TMP/SMZ was as
effective as 6 weeks of treatment with the same drug in women with kidney infections that did not
involve an obstruction or nervous system disorder. In such cases, kidney infections rarely lead to
kidney damage or kidney failure unless they go untreated.
Various drugs are available to relieve the pain of a UTI. A heating pad or a warm bath may also help.
Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. For the
time being, it is best to avoid coffee, alcohol, and spicy foods. (And one of the best things a smoker
can do for his or her bladder is to quit smoking.
cancer.)
Recurrent Infections in Women
Many women have them even
more often. A woman who has frequent recurrences (three or more a year) should ask her doctor
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 and may be more 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 color when an infection is present are now available without prescription. The
strips detect nitrite, which is formed when bacteria change nitrate the urine to nitrate. The test can
Drink plenty of water every day. Some doctors suggest drinking cranberry juice, which in large
amounts inhibits the growth of some bacteria by acidifying the urine. Vitamin C (Ascorbic Acid)
Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra;
Cleanse the genital area before sexual intercourse;
A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery of her
baby and other risks such as high blood pressure. Some antibiotics are not safe to take during
pregnancy. In selecting the best treatments, doctors consider various factors such as the drug's
effectiveness, the stage of pregnancy, the mother's health, and potential effects on the fetus.
Complicated Infections
Curing infections that stem from a urinary obstruction or nervous system disorder depends on finding
and correcting the underlying problem, sometimes with surgery. If the root cause goes untreated, this
group of patients is at risk of kidney damage. Also, such infections tend to arise from a wider range of
UTI's are unusual in men. They usually stem from an obstruction -- for example, a urinary stone or
enlarged prostate -- or a medical procedure involving a catheter. The first step is to identify the
symptoms of urinary tract infection in childrenUsually, doctors recommended lengthier
Prostate infections
(prostatitis) are harder to cure because antibiotics are unable to penetrate infected prostate tissue
effectively.
selected antibiotic.
Research in Urinary System Disorders
The NIH conducts and supports a variety of research in diseases of the kidney and urinary tract.
knowledge gained from these studies is advancing scientific understanding of why UTI's develop and
is leading to improved methods of diagnosing, treating, and preventing infections.
Information provided by the NIH & NIDDK
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gymnastics-grip-bags
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Infections of the urinary tract are common -- only respiratory infections occur more often. Each year,
Women are especially prone
to UTI's for reasons that are poorly understood. One woman in five develops a UTI during her
signs and symptoms of urinary tract infection
The Urinary Tract
The urinary system consists of the kidneys, ureters, bladder, and urethra. The key players 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 liquid waste 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. urinary tract infection symptoms womenNarrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped
Urine is stored in the bladder and emptied through the urethra.
The average adult passes about a quart and a half of urine each day. The amount of urine varies,
The volume formed at night is about half that
formed in the daytime.
Causes
It contains fluids, salts, and waste products, but it is free of bacteria, viruses,
and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to
the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria,
coli), which normally live in the colon. In most cases, bacteria first begin growing
in the urethra. An infection limited to the urethra is called urethritis. From there bacteria often move on
to the bladder, causing a bladder infection (cystitis).
may then go up the ureters to infect the kidneys (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.
Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both
partners. 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 both sexes, immune defenses also prevent infection.
though, infections still occur.
Some people are more prone to getting a UTI than others.
obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. An enlarged
prostate gland also can slow the flow of urine,urinary tract infection symptoms thus raising the risk of infection. A common source of
infection is catheters, or tubes, placed in the bladder. A person who cannot void, is unconscious or
especially the elderly or those with nervous system disorders who lose bladder control, may need a
catheter for life. Bacteria on the catheter can infect the bladder, so hospital staff take special care to
keep the catheter sterile and remove it as soon as possible.
People with diabetes have a higher risk of a UTI because of changes of the immune system.
disorder that suppresses the immune system raises the risk of a urinary infection. UTI's may occur in
infants who are born with abnormalities of the urinary tract, which sometimes need to be corrected
with surgery. UTI's are rarely seen in boys and young men.
UTI's gradually increases with age. Scientists are not sure why women have more urinary infections
One factor may be that a woman's urethra is short, allowing bacteria quick access to the
bladder.
unclear. According to several studies, women who use a diaphragm are more likely to develop a UTI
than women who use other forms of birth control.
coli bacteria in the
vagina.
Recurrent Infections
Many women suffer from frequent UTI's. Nearly 20 percent of women who have a UTI will have
another, and 30 percent of those will have yet another. Of the last group, 80 percent will have
recurrences. Usually, the latest infection stems from a strain or type of bacteria that is different from
(Even when several UTI's in a row are due to E.
coli, slight differences in the bacteria indicate distinct infections.)
Research funded by the National Institutes of Health (NIH) suggests that one factor behind recurrent
UTI's may be the ability of bacteria to attach to cells lining the urinary tract. A recent NIH funded
study has also shown that women with recurrent UTI's tend to have certain blood types. Some
scientists speculate that women with these blood types are more prone to UTI's because the cells
Further research will show
whether this association is sound and proves useful in identifying women at high risk for UTI's.
Infections in Pregnancy
Pregnant women seem no more prone to UTI's than other women. However, when a UTI does occur,
it is more likely to travel to the kidneys.
women develop a urinary infection.
the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For
this reason, many doctors recommend periodic testing of urine.
Symptoms
Not everyone with a UTI has symptoms, but most people get at least some. These may include a
frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during
not urinating. Often, women feel an uncomfortable urinary tract infection symptomspressure above the pubic bone, and some men
experience a fullness in the rectum. It is common for a person with a urinary infection to complain that,
despite the urge to urinate, only a small amount of urine is passed. The urine itself may look milky or
cloudy, even reddish if blood is present.
Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or
vomiting.
disorder. A UTI should be considered when a child or infant seems irritable, is not eating normally,
has an unexplained fever that does not go away, has incontinence or loose bowels, or is not thriving.
The child should be seen by a doctor if there are any questions about these symptoms, especially if
You
(This method of collecting urine helps prevent
bacteria around the genital area from getting into the sample and confusing the test results.) Usually,
In the urinalysis test, the urine is examined for male urinary tract infection symptomswhite and red blood cells and bacteria.
bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys
the bacteria. This last step is called a sensitivity test.
but a standard culture fails to grow any bacteria.
When an infection does not clear up with treatment and is traced to the same strain of bacteria, the
doctor will order a test that makes images of the urinary tract. One of these tests is an intravenous
pyelogram (IVP), which gives x-ray images of the bladder, kidneys, and ureters.
The film shows an outline
of the urinary tract, revealing even small changes in the structure of the tract.
If you have recurrent infections, your doctor also may recommend an ultrasound exam, which gives
test is cystoscopy.
patient's history and the urine tests that identify the offending bacteria. The sensitivity test is especially
useful in helping the doctor select the most effective drug.
uncomplicated UTI's are trimethoprim (Trimpex), trimethoprim/sufamethoxazole (Bactrim, Septra,
Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and
ampicillin. Often, a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated
by an obstruction or nervous system disorder. Still, many doctors ask their patients to take antibiotics
for a week or two to assure that the infection has been cured. Single-dose treatment is not
recommended for some groups of patients, for example, those who have delayed treatment or have
Longer treatment is also needed by patients with infections caused by
Mycoplasma or Chlamydia, which are usually treated with tetracycline, trimethoprim/sulfamethoxazole
(TMP/SMZ), or doxycycline.
infection-free.
treatment because symptoms may disappear before the infection is fully cleared.
drugs on their own. Kidney infections generally require several weeks of antibiotic treatment.
Researchers at the University of Washington found that 2-week therapy with TMP/SMZ was as
effective as 6 weeks of treatment with the same drug in women with kidney infections that did not
involve an obstruction or nervous system disorder. In such cases, kidney infections rarely lead to
kidney damage or kidney failure unless they go untreated.
Various drugs are available to relieve the pain of a UTI. A heating pad or a warm bath may also help.
Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. For the
time being, it is best to avoid coffee, alcohol, and spicy foods. (And one of the best things a smoker
can do for his or her bladder is to quit smoking.
cancer.)
Recurrent Infections in Women
Many women have them even
more often. A woman who has frequent recurrences (three or more a year) should ask her doctor
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 and may be more 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 color when an infection is present are now available without prescription. The
strips detect nitrite, which is formed when bacteria change nitrate the urine to nitrate. The test can
Drink plenty of water every day. Some doctors suggest drinking cranberry juice, which in large
amounts inhibits the growth of some bacteria by acidifying the urine. Vitamin C (Ascorbic Acid)
Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra;
Cleanse the genital area before sexual intercourse;
A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery of her
baby and other risks such as high blood pressure. Some antibiotics are not safe to take during
pregnancy. In selecting the best treatments, doctors consider various factors such as the drug's
effectiveness, the stage of pregnancy, the mother's health, and potential effects on the fetus.
Complicated Infections
Curing infections that stem from a urinary obstruction or nervous system disorder depends on finding
and correcting the underlying problem, sometimes with surgery. If the root cause goes untreated, this
group of patients is at risk of kidney damage. Also, such infections tend to arise from a wider range of
UTI's are unusual in men. They usually stem from an obstruction -- for example, a urinary stone or
enlarged prostate -- or a medical procedure involving a catheter. The first step is to identify the
symptoms of urinary tract infection in childrenUsually, doctors recommended lengthier
Prostate infections
(prostatitis) are harder to cure because antibiotics are unable to penetrate infected prostate tissue
effectively.
selected antibiotic.
Research in Urinary System Disorders
The NIH conducts and supports a variety of research in diseases of the kidney and urinary tract.
knowledge gained from these studies is advancing scientific understanding of why UTI's develop and
is leading to improved methods of diagnosing, treating, and preventing infections.
Information provided by the NIH & NIDDK
