Urinary Tract Infections

Urinary tract infections (UTI) occur when bacteria enter the urinary tract and urethra and multiply. These infections typically develop in the lower urinary tract before progressing to the upper urinary tract if they remain untreated. Bladder infections (cystitis) are the most common form of urinary tract infections, but UTIs can also manifest as infections of the urethra or kidneys. Women are more prone than men to developing UTIs. Children under the age of two can also develop this infection.

E.coli is the most common bacterial cause of UTIs. Other forms of bacteria can also cause UTIs. Men and women infected with some sexually transmitted diseases can transmit bacteria to their partner during sexual intercourse, causing a UTI.

Other UTI Risk Factors Include:

  • Long-term urinary catheterization
  • Soiled diapers in infants and toddlers
  • Bladder outlet obstructions, including, kidney stones or BPH
  • Incomplete bladder emptying
  • Congenital urinary tract abnormalities
  • Suppressed immune systems
  • Certain blood types that make it easier for bacteria to attach to the cells lining the urinary tract

Symptoms of UTIs occur differently in individuals depending on their age and the form of infection.

Symptoms in Young Children May Include:

  • Diarrhea
  • Loss of appetite
  • Fever
  • Nausea and vomiting
  • Excessive crying for unknown reasons

Symptoms in Older Children May Include:

  • Frequent urination
  • Incontinence
  • Painful urination
  • Cloudy or unusual smelling urine
  • Continuous production of small amounts of urine
  • Abdomen or pelvic area pain
  • Flank or lower back pain (with a kidney infection)

Symptoms of Lower UTIs May Include:

  • Back pain
  • Blood in the urine
  • Cloudy urine
  • Inability to urinate
  • Frequent urination
  • Painful urination
  • Pelvic discomfort

Symptoms of Upper UTIs May Include:

  • Chills
  • High fever
  • Nausea
  • Vomiting
  • Pain below the ribs

Tests

A UTI is diagnosed through a clean-catch urine specimen. A clean-catch specimen is obtained by cleansing the area around the urethral opening or by catheterization and collecting a midstream urine sample. Then, a urinalysis is performed to determine a white blood cell count (WBC) or look for bacteria or nitrates in the urine. These may indicate a bacterial infection. Newer tests include PCR panels and Next Gen Sequencing (NGS) using tests such as Pathnostics and Microgen. Many patients that historically have been treated for Interstitial Cystitis or pelvic pain are now being found to have chronic cystitis.

Treatments

Bladder and urinary tract infections are typically treated with antibiotic medication. The dosage and length of time of the prescription depends on the form of infection.

Patients Can Take the Following Measures to Prevent UTIs:
  • Change soiled diapers promptly
  • Drink lots of water
  • Rarely resist the urge to urinate
  • Urinate after sexual intercourse
  • Natural treatments including proanthocyanidins (PAC) to help prevent recurrent UTI