Paper on The Diagnosis and Treatment of Urinary Tract Infection

The Diagnosis and Treatment of Urinary Tract Infection

Urinary tract infection (UTI) affects the urinary system including the kidneys, bladder, ureters, and urethra (Mayo Clinic, 2017). It is the most common bacterial infection accompanied by pain and a burning sensation when passing urine. There are three types of UTI depending on the infected part. Acute pyelonephritis affects the kidneys, cystitis occurs in the bladder, while urethritis disturbs the urethra. People of all ages can suffer from UTI; however, women bear higher risks. According to the National Kidney Foundation (2017), women are more likely to develop UTI since they have shorter urethra, which makes it easier for bacteria to travel to the bladder. It can also happen in childhood with a higher incidence in girls than boys (Obi & Sinha, 2007). During early infancy, boys are exposed to UTI due to congenital malformations in the urinary tract; although girls are more prone to the infection. In girls, a combination of a shorter urethra, dysfunctional bladder emptying, and vesicoureteric reflux increase chances of getting UTI. Thus, it is critical to explore risk factors causing the disease including its diagnosis and treatment.

Causes and Symptoms of UTI

UTI develops when bacteria go through the urethra to the urinary tract and start multiplying in the bladder. Naturally, the urinary system is designed to fight the bacteria on its own, but it can fail sometimes. When the defense mechanism of the system breaks down, bacteria may grow into a full-blown infection. For instance, cystitis is often caused by Escherichia coli (E. coli), a bacterium that lives in the gastrointestinal tract (Mayo Clinic, 2017). However, other types of bacteria can also be responsible for causing the disease. Cystitis can be acquired through sexual intercourse, although one does not have to be sexually active to contract the infection. In females, if there is short distance from the anus to the vagina, it is easier for the GI bacteria to travel to the urethra. In addition, sexually transmitted diseases like gonorrhea, herpes, mycoplasm, and chlamydia can cause urethritis as well.

Symptoms

The most common symptoms of UTI are the following.

  • A frequent and persistent urge to urinate
  • A burning sensation during urination
  • Passing small amounts of urine frequently
  • Blood in urine
  • Cloudy or smelly urine
  • Pelvic pain in women

Nausea and vomiting, high fever, shakes and chills, and flank pain may be a sign of pyelonephritis (Mayo Clinic, 2017). In children, symptoms may include high fever, prolonged jaundice, poor feeding and weight loss, or the occurrence of a severe illness (Obi & Sinha, 2007).

Treatment and Diagnosis of UTI

Diagnosis

The first procedure is the analysis of the urine sample which is taken to the lab and tested for red blood cells, white blood cells, or bacteria. A patient should be instructed to collect the sample midstream and to first wipe the genital area with an antiseptic pad to avoid contamination. Urine culture is then examined in the lab to reveal the bacteria-causing infection. It may also require performing an ultrasound, a magnetic resonance imaging (MRI), or a computerized tomography of the urinary tract to find abnormal frequent infections. In addition, a doctor can apply a contrast dye in the urinary tract to highlight specific areas. Recurrent UTIs may require doing cystoscopy. During this procedure, a long thin tube lens in the urethra and bladder is used (Mayo Clinic, 2007).

Treatment

The type of drugs prescribed and their period of usage depend on the patient’s condition and the type of bacteria. For simple infections of the urinary tract, doctors may recommend such antibiotics as fosfomycin, nitrofurantoin, ceftriaxone, cephalexin, and trimethoprim. Other groups of antibiotics like floroquinolones and levofloxacin are not commonly prescribed as their risks outweigh the benefits. In children, quinolones should be avoided since according to the studies, there are cases of arthopathy in animals (Obi & Sinha, 2007). Symptoms mostly disappear within a few days of treatment, although it is recommended to continue a course of antibiotics for at least a week (NHS, 2017). In addition, frequent infections may require taking low-dose antibiotics for six months or longer, a single dose of antibiotic after sexual intercourse if it is the cause of the disease, and vaginal estrogen therapy for postmenopausal patients.

Risk Factors and Prevention

For women, the main risk factors are the female anatomy, sexual activity, specific types of birth control, and menopause. Others include blockages in the urinary tract, suppressed immune system, use of catheter, recent urinary procedure, and urinary tract abnormalities (NHS, 2017). To reduce the risks of having UTI, it is advisable to drink plenty of water and cranberry juice, wipe from front to back, empty bladder soon after intercourse, use alternative birth control methods, and do not use irritating feminine products.

Conclusion

UTI is the infection of the urinary system caused by bacteria. There are three types of UTI namely acute pyelonephritis, cystitis, and urethritis. The disease is accompanied by a series of symptoms which include a burning sensation when passing urine, persistent urge to urinate, smelly urine, and others. To diagnose UTI, a lab analysis of a urine sample is performed to determine the type of bacteria and prescribe correct medication. Severe cases may require prolonged use of antibiotics and vaginal estrogen therapy. Main risk factors of UTI include the female anatomy, pregnancy, poor immune system, recent urinary procedure, and others. Thus, it is important to take preventive measures which include drinking enough water or cranberry juice, avoiding harmful feminine products, and emptying bladder immediately after sexual intercourse

 

References

Mayo Clinic. (2017). Urinary tract infection (UTI). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453

National Kidney Foundation. (2017). Top 10 things to know about urinary tract infections. National Kidney Foundation. Retrieved from https://www.kidney.org/transplantation/transaction/TC/winter11/TCwinter11_UTI

NHS. (2017). Urinary tract infections (UTIs). NHS. Retrieved from https://www.nhs.uk/conditions/urinary-tract-infections-utis/

Obi, B., & Sinha, M. (2007). Diagnosis and treatment of urinary tract infection in children. Prescriber, 66-71. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1002/psb.24