Urinary Tract Infection (UTI)

Urinary tract infection (UTI) is the most common bacterial infection. Upto 50% of women have a UTI at sometime. The prevalence of UTI in women is about 3% at the age of 20, increasing by about 1% in each subsequent decade. In males UTI is uncommon, except in the first year of life and in men over 60, in whom urinary tract obstruction due to prostatic hypertrophy may occur. UTI causes morbidity and, in a small minority of cases, renal damage and chronic renal failure.

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Causes of Urinary tract infection

Organisms causing UTI in the community include:-
• Escherichia coli
• Proteus
• Pseudomonas species
• Streptococci
• Staphylococcus epidermidis

 

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Symptoms of UTI

Typical Features of Cystitis and Urethritis include:
• Abrupt onset of frequency of micturition.
• Scalding pain in the urethra during micturition (dysuria).
• Suprapubic Pain during and after voiding.
• Intense desire to pass more urine after micturition, due to spasm of the inflamed bladder wall (urgency).
• Urine that may appear cloudy and have an unpleasant odour.
• Microscopic or visible haematuria.

 
Investigations

• Routine urine examination
• Mid-stream urine culture and sensitivity
• Complete blood count
• Serum creatinine, blood urea and electrolytes
• Ultrasonography of kidney, ureter, bladder.
• Pelvic (women) and rectal (men) examination.
• Intravenous urography for any anatomical/physiological anamolies.
• Micturating cystourethrography for vesico-ureteric reflux.
• Cystoscopy.
• Blood culture in septicaemic cases.

 

Preventions

• Periodic complete emptying of bladder every few hours during the day and before going to bed.
• Fluids intake of at least 2 litres/day.
• To empty bladder before and after sexual intercourse.
• In case or reflux, empty bladder twice at an interval of 15 minutes before retiring to bed.
• Good personal hygiene.
• Cranberry juice may be effective.

 

References-

• Davidson’s Principles & Practice of Medicine.
• API textbook of Medicine.