Urinary tract infections (UTIs) occur when bacteria grow in the urinary system, which includes the kidneys, ureters, bladder, and urethra. UTIs are common in women due to anatomical factors, but they can affect anyone. Most infections are mild and easily treatable, but serious complications may occur if the infection reaches the kidneys.
Types of UTIs
- Cystitis – infection of the bladder (most common)
- Urethritis – infection of the urethra
- Pyelonephritis – infection of the kidneys (serious)
- Complicated UTI – occurs in pregnancy, diabetes, catheter use, or structural abnormalities
Causes of UTI
The majority of UTIs are caused by bacteria, especially:
- E. coli (most common)
- Klebsiella
- Proteus
- Enterococcus
- Pseudomonas (hospital-acquired)
Yeast infections (Candida) may affect immunocompromised patients.
Risk Factors
- Female gender
- Poor hydration
- Sexual activity
- Pregnancy
- Diabetes
- Urinary catheters
- Kidney stones
- Post-menopausal women
Symptoms
- Burning sensation while urinating
- Frequent urination
- Lower abdominal pain
- Cloudy or foul-smelling urine
- Blood in urine
- Fever and chills (in pyelonephritis)
- Back or flank pain (kidney involvement)
Diagnosis
- Urinalysis – detects WBCs, nitrites, bacteria
- Urine culture – identifies organism and antibiotic sensitivity
- Ultrasound – for recurrent or complicated cases
Treatment of UTI
Uncomplicated Cystitis
- Nitrofurantoin for 5 days
- Fosfomycin single dose
- Trimethoprim–sulfamethoxazole for 3 days (if local resistance low)
Complicated UTI
- Ciprofloxacin or levofloxacin
- Amoxicillin–clavulanate
- Third-generation cephalosporins
Pyelonephritis (Kidney Infection)
- Oral fluoroquinolones (ciprofloxacin)
- IV ceftriaxone or piperacillin–tazobactam for severe cases
UTI in Pregnancy
- Safe drugs: amoxicillin, cephalexin, nitrofurantoin (avoid after 38 weeks)
- Avoid fluoroquinolones and tetracyclines
Supportive Management
- Hydration to flush bacteria
- Pain relief with paracetamol
- Urinary alkalinizers for symptom relief
Complications
- Kidney damage (chronic pyelonephritis)
- Sepsis
- Preterm labor (in pregnancy)
- Recurrent UTIs
Prevention
- Drink plenty of water
- Wipe from front to back
- Avoid holding urine for long periods
- Maintain genital hygiene
- Urinate after sexual activity
- Avoid unnecessary catheter use
Patient Counseling
- Complete the full antibiotic course
- Increase fluid intake
- Avoid irritants like caffeine and alcohol
- Report fever, flank pain, or worsening symptoms
- Seek evaluation for recurrent infections
Detailed Notes:
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