URINARY TRACT INFECTION

Urinary Tract Infection

Urinary tract infection (UTI) is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract. The urinary tract includes the kidneys, the tubes that carry urine from the kidneys to the bladder (ureters), bladder, and the tube that carries urine from the bladder (urethra). The special connection of the ureters at the bladder help prevent urine from backing up into the kidneys, and the flow of urine through the urethra helps to eliminate bacteria. Men, women, and children develop UTIs.

Types

Urinary tract infections usually develop first in the lower urinary tract (urethra, bladder) and, if not treated, progress to the upper urinary tract (ureters, kidneys). Bladder infection (cystitis) is by far the most common UTI. Infection of the urethra is called urethritis. Kidney infection (pyelonephritis) requires urgent treatment and can lead to reduced kidney function and possibly even death in untreated, severe cases.

Signs and Symptoms

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  • Diarrhea
  • Excessive crying that cannot be resolved by typical measures (e.g., feeding, holding)
  • Loss of appetite
  • Fever
  • Nausea and vomiting

Older children may experience the following symptoms with UTI:

  • Flank or lower back pain (with a kidney infection)
  • Frequent urination
  • Inability to produce more than a small amount of urine at a time
  • Incontinence
  • Pain in the abdomen or pelvic area
  • Painful urination (dysuria)
  • Urine that is cloudy or has an unusual smell

Symptoms of lower UTI (e.g., cystitis, urethritis) in adults include the following:

  • Back pain
  • Blood in the urine (hematuria)
  • Cloudy urine
  • Inability to urinate despite the urge
  • Fever
  • Frequent need to urinate
  • General discomfort (malaise)
  • Painful urination (dysuria)

Symptoms that indicate upper UTI (e.g., pyelonephritis) in adults include the following:

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

Complications

Hormonal changes and shifts in the urinary tract during pregnancy increase the risk for kidney infection. Prenatal care includes regular urine testing because bacteria are often present without causing symptoms and UTI during pregnancy may result in complications (e.g., premature birth, high blood pressure) for the mother and fetus. Diseases that suppress the immune system (e.g., HIV) and debilitating diseases (e.g., cancer, sickle cell anemia) increase the risk for UTIs and complications.

Prevention

The following measures can reduce the risk for bladder infections and other UTIs:

  • Avoid products that may irritate the urethra (e.g., bubble bath, scented feminine products).
  • Cleanse the genital area before sexual intercourse.
  • Change soiled diapers in infants and toddlers promptly.
  • Drink plenty of water to remove bacteria from the urinary tract.
  • Do not routinely resist the urge to urinate.
  • Take showers instead of baths.
  • Urinate after sexual intercourse.
  • Women and girls should wipe from front to back after voiding to prevent contaminating the urethra with bacteria from the anal area.