INTRODUCTION: URINARY TRACT INFECTION
What is a urinary tract infection (UTI)?
The urinary tract is comprised of the kidneys, ureters, bladder, and urethra. A urinary tract infection (UTI) is an infection caused by pathogenic organisms (for example, bacteria, fungi, or parasites) in any of the structures that comprise the urinary tract. However, this is the broad definition of urinary tract infections; many authors prefer to use more specific terms that localize the urinary tract infection to the major structural segment involved such as urethritis(urethral infection), cystitis(bladder infection), ureter infection, and pyelonephritis. Other structures that eventually connect to or share close anatomic proximity to the urinary tract (for example, prostate, epididymis, and vagina) are sometimes included in the discussion of UTIs because they may either cause or be caused by UTIs. Technically, they are not UTIs and will be only briefly mentioned in this article. UTIs are common, more common in women than men, leading to approximately 8.3 million doctor visits per year. Although some infections go unnoticed, UTIs can cause problems that range from dysuria (pain and/or burning when urinating) to organ damage and even death. The kidneys are the active organs that, during their average production of about 1.5 quarts of urine per day, function to help keep electrolytes and fluids (for example, potassium, sodium, water) in balance, assist removal of waste products (urea), and produce a hormone that aids to form red blood cells. If kidneys are injured or destroyed by infection, these vital functions can be damaged or lost. While some investigators state that UTIs are not transmitted from person to person, other investigators dispute this and say UTIs may be contagious and recommend that sex partners avoid relations until the UTI has cleared. There is no dispute about UTIs caused by sexually transmitted disease(STD) organisms; these infections (gonorrhea, Chlamydia) are easily transmitted between sex partners and are very contagious.
What causes a UTI?
The most common causes of UTI infections (about 80%) are Escherichia coli bacterial strains that usually inhabit the colon. However, many other bacteria can occasionally cause an infection (for example, Klebsiella, Pseudomonas, Enterobacter, Proteus, Staphylococcus, Mycoplasma, Chlamydia, Serratia and Neisseria spp) but are far less frequent causes than E. coli. In addition, fungi (Candida and Cryptococcusspp) and some parasites (Trichomonas, Schistosoma) also may cause UTIs;Schistosoma causes other problems, withbladder infections as only a part of its complicated infectious process. In the U.S., most infections are due to Gram-negative bacteria with E. coli causing the majority of infections. What are UTI risk factors?
* any interruption or impedance of the usual flow of urine (about 50 cc per hour in normal adults) is a risk factor for a UTI. * People who require catheters have an increased risk (about 30% of patients with indwelling catheters get UTIs) as the catheter has none of the protective immune systems to eliminate bacteria and offers a direct connection to the bladder. * women who use a diaphragm or who have partners that use condoms with spermicidal foam are at increased risk for UTIs * females who become sexually active seem to have a higher risk of UTI; some investigators term these UTIs as "honeymoon cystitis." * Men over 60 have a higher risk for UTIs because many men at or above that age develop enlarged prostates that may cause slow and incomplete bladder emptying. Stages of urinary tract infection:
* the urethra can become infected. This urinary tract infection is more commonly with sexually transmitted diseases. * the bladder can become infected and, commonly, that's where most of the urinary tract infections occur. * urinary infections can ascend up into the kidneys, causing an issue with kidney infections....
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