Urinary Tract Infection UTI

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. The main etiologic agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it does not usually have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they may cause a UTI.

The most common type of UTI is acute cystitis often referred to as a bladder infection. An infection of the upper urinary tract or kidney is known as pyelonephritis, and is potentially more serious. Although they cause discomfort, urinary tract infections can usually be easily treated with a short course of antibiotics. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine.

• Most common in females because of anatomy of the lower urinary tract: urethra is short and meatus  is close to the anus.
• Peak incidence occurs at 2 to 5 years of age.

Prevention

The following are measures that studies suggest may reduce the incidence of urinary tract infections.

• A prolonged course (six months to a year) of low-dose antibiotics (usually nitrofurantoin or TMP/SMX) is effective in reducing the frequency of UTIs in those with recurrent UTIs.
• Cranberry (juice or capsules) may decrease the incidence of UTI in those with frequent infections. Long term tolerance however is an issue.
• For post-menopausal women intra vaginal application of topical estrogen cream can prevent recurrent cystitis. This however is not as useful as low dose antibiotics.
• Studies have shown that breastfeeding can reduce the risk of UTIs in infants.

A number of measures have not been found to affect UTI frequency including: the use of birth control pills or condoms, voiding after sex, the type of underwear used, personal hygiene methods used after voiding or defecating, and whether one takes a bath or shower.

Therapeutic interventions.

• antibiotics to eliminate infection.
• Identiry and correct structural anomalies if present.
• Bland, high-protein, high carbohydrate diet.
• Prevent recurrence; preserve renal function.