A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. Although urine contains a variety of fluids, salts, and waste products, it usually does not have bacteria in it.[1] When bacteria get into the bladder or kidney and multiply in the urine, they cause a UTI. The most common type of UTI is a bladder infection which is also often called cystitis. Another kind of UTI is a kidney infection, known as pyelonephritis, and is much more serious. Although they cause discomfort, urinary tract infections are usually quickly and easily treated by seeing a doctor promptly.[2] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... An infection is the detrimental colonization of a host organism by a foreign species. ... The urinary system is a system of organs, tubes, muscles, and nerves that work together to create, store, and carry, urine. ... Pyelonephritis is an ascending urinary tract infection that has reached the pyelum (pelvis) of the kidney (nephros in Greek). ...

Symptoms & Signs

For Bladder Infections

• Frequent urination along with the feeling of having to urinate even though little or no urine actually comes out.
• Nocturia: Need to urinate during the night.
• Urethritis: Discomfort or pain at the urethral meatus or a burning sensation throughout the urethra with urination (dysuria).
• Cystitis: Pain in the midline suprapubic region.
• Pyuria/Hematuria: Pus or blood in urine.
• Pyrexia: Mild fever
• Discharge from the urethra.
• Cloudy and foul-smelling urine
• Increased confusion and associated falls are common presentations to Emergency Departments for elderly patients with UTI.
• Some urinary tract infections are asymptomatic.

Polyuria is the passage of a large volume of urine in a given period. ... Urination, also called micturition, is the process of disposing urine from the urinary bladder through the urethra to the outside of the body. ... Nocturia is the need to get up during the night in order to urinate, thus interrupting sleep. ... Urethritis is an inflammation of the urethra. ... In anatomy, the urethra is a tube which connects the urinary bladder to the outside of the body. ... In anatomy, a meatus is a natural body opening or canal (pl. ... Urination, formally called micturition, is the process of disposing urine from the urinary bladder through the urethra to the outside of the body. ... In medicine, specifically urology, dysuria refers to any difficulty in urination. ... Suprapubic is a medical term referring to the area of the body that is situated above, or anterior to, the pubic bone. ... In medicine, Pyuria refers to urine which contains white blood cells. ... In medicine, hematuria (or haematuria) is the presence of blood in the urine. ... Fever is also the name of an album by Kylie Minogue. ... An analogue medical thermometer showing the temperature of 38. ... In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ...

For Kidney Infections

• The above symptoms.
• Emesis: Vomiting is common.
• Back, side (flank) or groin pain.
• Abdominal pain or pressure.
• Shaking chills and high spiking fever.
• Night Sweats.
• Extreme Fatigue.

Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ...

Diagnosis

A patient with dysuria (painful voiding) and urinary frequency generally has a spot mid-stream urine sample sent for urinalysis, specifically the presence of nitrites, leukocytes or leukocyte esterase. If there is a high bacterial load without the presence of leukocytes, it is most likely due to contamination. The diagnosis of UTI is confirmed by a urine culture. In medicine, specifically urology, dysuria refers to any difficulty in urination. ... A urinalysis (or UA) is an array of tests performed on urine and one of the most common methods of medical diagnosis. ... // Definition The nitrite ion is NO2−. A nitrite compound is one that contains this group, either an ionic compound, or an analogous covalent one. ... White Blood Cells is also the name of a White Stripes album. ... Leukocyte esterase (LE) is a urine test for the presence of white blood cells and other abnormalities associated with infection. ... A microbiological culture is a way to determine the cause of infectious disease by letting the agent multiply (reproduce) in predetermined media. ...

If the urine culture is negative:

• symptoms of urethritis may point at Chlamydia trachomatis or Neisseria gonorrheae infection.
• symptoms of cystitis, may point at interstitial cystitis.
• in men, prostatitis may present with dysuria.

In severe infection, characterised by fever, rigors or flank pain, urea and creatinine measurements may be performed to assess whether renal function has been affected. Binomial name Chlamydia trachomatis Busacca, 1935 Chlamydia trachomatis is a species of the chlamydiae, a group of obligately intracellular bacteria. ... Neisseria is a genus of bacteria, included among the proteobacteria, a large group of gram-negative forms. ... Interstitial cystitis (commonly abbreviated to IC) is a urinary bladder disease of unknown cause characterised by urinary frequency (as often as every 10 minutes), urgency, pressure and/or pain in the bladder and/or pelvis. ... Prostatitis is any form of inflammation of the prostate gland. ... An analogue medical thermometer showing the temperature of 38. ... A rigor is an episode of shaking occurring during a high fever. ... Urea is an organic compound of carbon, nitrogen, oxygen and hydrogen, with the formula CON2H4 or (NH2)2CO. Urea is also known as carbamide, especially in the recommended International Nonproprietary Names (rINN) in use in Europe. ... Chemical structure of creatinine. ... In medicine (nephrology) renal function is an indication of the state of the kidney and its role in physiology. ...

Causative agents

Common organisms that cause UTIs include: Escherichia coli and Staphylococcus saprophyticus. Less common organisms include Proteus mirabilis, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas and Enterococcus spp. E. coli redirects here. ... Staphylococcus saprophyticus is a coagulase-negative species of Staphylococcus which is often implicated in urinary tract infection. ... Binomial name Proteus mirabilis Hauser 1885 Proteus mirabilis is a Gram-negative, facultatively anaerobic bacterium. ... Binomial name Klebsiella pneumoniae (Schroeter 1886) Trevisan 1887 Klebsiella pneumoniae is a Gram-negative, nonmotile, encapsulated, lactose-fermenting, facultatively anaerobic, rod-shaped bacterium found in the normal flora of the mouth, skin, and intestines. ... Species etc. ... Species group P. aeruginosa P. alcaligenes P. anguilliseptica P. argentinensis P. citronellolis P. flavescens P. mendocina P. nitroreducens P. oleovorans P. pseudoalcaligenes P. resinovorans P. straminea group P. aurantiaca P. aureofaciens P. chlororaphis P. fragi P. lundensis P. taetrolens group P. antarctica P. azotoformans P. cedrina P. corrugata P. fluorescens... Species E. faecalis etc. ...

A mnemonic that can be used to remember the bacteria that cause UTIs is SEEK PP (Staph saprophyticus, E. coli, Enterococcus, Klebsiella, Proteus, Pseudomonas). Wikiquote has a collection of quotations related to: English mnemonics A mnemonic (pronounced in RP, [nɪmɑnɪk] in GA) is a memory aid, and most serve an educational purpose. ... Species group P. aeruginosa P. alcaligenes P. anguilliseptica P. argentinensis P. citronellolis P. flavescens P. mendocina P. nitroreducens P. oleovorans P. pseudoalcaligenes P. resinovorans P. straminea group P. aurantiaca P. aureofaciens P. chlororaphis P. fragi P. lundensis P. taetrolens group P. antarctica P. azotoformans P. cedrina P. corrugata P. fluorescens...

Prevention

The following are measures that studies suggest may reduce the incidence of urinary tract infections. These may be appropriate for people, especially women, with recurrent infections: In optics one considers angles of incidence. ...

• Cleaning the urethral meatus (the opening of the urethra) after intercourse has been shown to be of some benefit; however, whether this is done with an antiseptic or a placebo ointment (an ointment containing no active ingredient) does not appear to matter.^[1]
• It has been advocated that cranberry juice can decrease the incidence of UTI (some of these opinions are referenced in External Links section). A specific type of tannin found only in cranberries and blueberries prevents the adherence of certain pathogens (eg. E. coli) to the epithelium of the urinary bladder. A review by the Cochrane Collaboration of randomized controlled trials states 'some evidence from trials to show cranberries (juice and capsules) can prevent recurrent infections in women. Many people in the trials stopped drinking the juice, suggesting it may not be a popular intervention'.^[2]
• For post-menopausal women, a randomized controlled trial has shown that intravaginal application of topical estrogen cream can prevent recurrent cystitis.^[3] In this study, patients in the experimental group applied 0.5 mg of estriol vaginal cream nightly for two weeks followed by twice-weekly applications for eight months.
• Often long courses of low dose antibiotics are taken at night to help prevent otherwise unexplained cases of recurring cystitis.
• Acupuncture has been shown to be effective in preventing new infections in recurrent cases.^[4][5][6] One study showed that urinary tract infection occurrence was reduced by 50% for 6 months.^[7] However, this study has been criticized for several reasons.^[8] Acupuncture appears to reduce the total amount of residual urine in the bladder^{[citation needed]}. All of the studies are done by one research team without independent reproduction of results.

The following measures seem sensible, but have not been studied:^{[citation needed]} In anatomy, a meatus is a natural body opening or canal (pl. ... In anatomy, the urethra is a tube which connects the urinary bladder to the outside of the body. ... It has been suggested that Duration of sexual intercourse be merged into this article or section. ... An antiseptic solution of iodine applied to a cut Antiseptics (Greek αντί, against, and σηπτικός, putrefactive) are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. ... “Placebo effect” redirects here. ... Species Vaccinium erythrocarpum Vaccinium macrocarpon Vaccinium microcarpum Vaccinium oxycoccus Approximate ranges of the cranberries in sect. ... In optics one considers angles of incidence. ... Tannins are astringent, bitter-tasting plant polyphenols that bind and precipitate proteins. ... It has been suggested that this article or section be merged into Compliance (medicine). ... A pathogen (literally birth of pain from the Greek παθογένεια) is a biological agent that can cause disease to its host. ... Types of epithelium This article discusses the epithelium as it relates to animal anatomy. ... The Cochrane Collaboration developed in response to Archie Cochranes call for systematic, up-to-date reviews (currently known as systematic reviews) of all relevant randomized clinical trials of health care. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ... Acupuncture chart from Hua Shou (fl. ...

• Cleaning genital areas prior to and after sexual intercourse.
• For sexually active women, and to a lesser extent men, urinating within 15 minutes of sexual intercourse to allow the flow of urine to expel the bacteria before specialized extensions anchor the bacteria to the walls of the urethra.
• Having adequate fluid intake, especially water.
• Not resisting the urge to urinate.
• Taking showers, not baths, or urinating soon after taking a bath.
• Practicing good hygiene, including wiping from the front to the back to avoid contamination of the urinary tract by fecal pathogens.

It has been suggested that Duration of sexual intercourse be merged into this article or section. ...

Epidemiology

UTIs are most common in sexually active women, and increase in diabetics and people with sickle-cell disease or anatomical malformations of the urinary tract. For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Sickle-cell disease is a group of genetic disorders caused by sickle hemoglobin (Hgb S or Hb S). ...

Allergies can be a hidden factor in urinary tract infections. For example, allergies to foods can irritate the bladder wall and increase susceptibility to urinary tract infections. Keep track of your diet and have allergy testing done to help eliminate foods that may be a problem. Urinary tract infections after sexual intercourse can be also be due to an allergy to latex condoms, spermicides, or oral contraceptives. In this case review alternative methods of birth control with your doctor.

The use of urinary catheters in both men and women who are elderly, people experiencing nervous system disorders and people who are convalescing or unconscious for long periods of time may result in an increased risk of urinary tract infection for a variety of reasons. Scrupulous aseptic technique may decrease this risk. In urinary catheterization, a urinary catheter, (such as a Foley catheter) is a slender plastic tube which is inserted through a patients urinary tract into their bladder. ...

The bladder wall is coated with various mannosylated proteins, such as Tamm-Horsfall proteins (THP), which interfere with the binding of bacteria to the uroepithelium. As binding is an important factor in establishing pathogenicity for these organisms, its disruption results in reduced capacity for invasion of the tissues. Moreover, the unbound bacteria are more easily removed when voiding. The use of urinary catheters (or other physical trauma) may physically disturb this protective lining, thereby allowing bacteria to invade the exposed epithelium.

Elderly individuals, both men and women, are more likely to harbor bacteria in their genitourinary system at any time. These bacteria may be associated with symptoms and thus require treatment with an antibiotic. The presence of bacteria in the urinary tract of older adults, without symptoms or associated consequences, is also a well recognized phenomenon which may not require antibiotics. This is usually referred to as asymptomatic bacteriuria. The overuse of antibiotics in the context of bacteriuria among the elderly is a concerning and controversial issue.

Women are more prone to UTIs than males because in females, the urethra is much shorter and closer to the anus than in males. The article on vulvovaginal health has some health tips for preventing UTIs. In anatomy, the urethra is a tube which connects the urinary bladder to the outside of the body. ... Female Human Anatomy Male Human Anatomy This article is about the bodily orifice. ... Vulvovaginal health is the health and sanitation of the human female vulva and vagina. ...

A common cause of UTI is an increase in sexual activity, such as vigorous sexual intercourse with a new partner. The term "honeymoon cystitis", although somewhat demeaning, has been applied to this phenomenon[3].

Treatment

Most uncomplicated UTIs can be treated with oral antibiotics such as trimethoprim, cephalosporins, nitrofurantoin, or a fluoroquinolone (e.g. ciprofloxacin, levofloxacin). Whilst co-trimoxazole was previously internationally used (and continues to be used in the U.S.), the additional of the sulphonamide gave little additional benefit compared to the trimethoprim component alone, but was responsible for its both high incidence of mild allergic reactions and rare but serious complications. Staphylococcus aureus - Antibiotics test plate. ... Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections (cystitis). ... The cephalosporins, are a class of β-lactam antibiotics. ... Nitrofurantoin is an antibiotic. ... Quinolones and fluoroquinolones form a group of broad-spectrum antibiotics. ... Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro and Ciproxin (and other brand names in other markets, e. ... Levofloxacin is relatively new fluoroquinolone antibiotic, marketed by Ortho-McNeil under the brand name Levaquin. ... Co-trimoxazole (abbreviated SXT) is a bacteriostatic antibiotic combination of trimethoprim and sulfamethoxazole, in the ratio of 1 to 5, used in the treatment of a variety of bacterial infections. ... Sulfonamides, also known as sulfa drugs, are synthetic antimicrobial agents derived from sulfonic acid. ...

If the patient has symptoms consistent with pyelonephritis, intravenous antibiotics may be indicated. Pyelonephritis is an ascending urinary tract infection that has reached the pyelum (pelvis) of the kidney (nephros in Greek). ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ...

Recurrent UTIs

Patients with recurrent UTIs may need further investigation. This may include ultrasound scans of the kidneys and bladder or intravenous urography (X-rays of the urological system following intravenous injection of iodinated contrast material). If there is no response to treatments, interstitial cystitis may be a possibility. Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structures and possible pathologies or lesions. ... Urography (also pyelography, intravenous urogram or IVU) is a medical examination procedure to check the function of the kidneys and its drain tubes (ureters). ... Interstitial cystitis (commonly abbreviated to IC) is a urinary bladder disease of unknown cause characterised by urinary frequency (as often as every 10 minutes), urgency, pressure and/or pain in the bladder and/or pelvis. ...

During cystitis, uropathogenic Escherichia coli (UPEC) subvert innate defenses by invading superficial umbrella cells and rapidly increasing in numbers to form intracellular bacterial communities (IBCs).^[9] E. coli redirects here. ...

Researchers at Center for Genomic Sciences, Allegheny Singer Research Institute, and the Department of Microbiology and Immunology, Drexel University College of Medicine have shown that biofilms are responsible for chronic infections and, from a clinical perspective, traditional antibiotic therapy will never be a successful treatment against biofilm bacteria.^[10]

References

External links

• NIH articles on Urinary Tract Infections in Adults and in Children.
• The IC Community (ICC)
• Drug Watch: Cranberry juice reduces bacteriuria and pyuria
• MedlinePlus Overview urinarytractinfections
• -375783424 at GPnotebook
• CNN article on kidney infections
• aboutinfections.com information on bladder infections