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Sabtu, 22 Desember 2012

Urinary tract infection (UTI)

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Urinary tract infection (UTI)

Definition  :
Urinary tract infection (UTI)
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A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.

Women are at greater risk of developing a UTI than men are. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.
Antibiotics are the typical treatment for a UTI. But you can take steps to reduce your chance of getting a UTI in the first place.

Symptoms:

Urinary tract infections don't always cause signs and symptoms, but when they do they may include:
  • A strong, persistent urge to urinate
  • A burning sensation when urinating
  • Passing frequent, small amounts of urine
  • Urine that appears cloudy
  • Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
  • Strong-smelling urine
  • Pelvic pain, in women
  • Rectal pain, in men
UTIs may be overlooked or mistaken for other conditions in older adults.
Types of urinary tract infection
Each type of UTI may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.
Part of urinary tract affectedSigns and symptoms
Kidneys (acute pyelonephritis)
  • Upper back and side (flank) pain
  • High fever
  • Shaking and chills
  • Nausea
  • Vomiting
Bladder (cystitis)
  • Pelvic pressure
  • Lower abdomen discomfort
  • Frequent, painful urination
  • Blood in urine
Urethra (urethritis)
  • Burning with urination
When to see a doctor
Contact your doctor if you have signs and symptoms of a UTI.

Causes:

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.
The most common UTIs occur mainly in women and affect the bladder and urethra.
  • Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. Sexual intercourse may lead to cystitis, but you don't have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.
  • Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea and chlamydia, can cause urethritis.
Complications:

When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences.
Complications of UTIs may include:
  • Recurrent infections, especially in women who experience three or more UTIs
  • Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI, especially in young children
  • Increased risk of women delivering low birth weight or premature infants
Treatments and drugs:

Doctors typically use antibiotics to treat urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacterium found in your urine.
Simple infection
Drugs commonly recommended for simple UTIs include:
  • Sulfamethoxazole-trimethoprim (Bactrim, Septra, others)
  • Amoxicillin (Amoxil, Augmentin, others)
  • Nitrofurantoin (Furadantin, Macrodantin, others)
  • Ampicillin
  • Ciprofloxacin (Cipro)
  • Levofloxacin (Levaquin)
Usually, symptoms clear up within a few days of treatment. But you may need to continue antibiotics for a week or more. Take the entire course of antibiotics prescribed by your doctor to ensure that the infection is completely gone.

For an uncomplicated UTI that occurs when you're otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is adequate to treat your infection depends on your particular symptoms and medical history.

Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating. One common side effect of urinary tract analgesics is discolored urine — orange or red.
Frequent infections
If you experience frequent UTIs, your doctor may make certain treatment recommendations, such as:
  • Longer course of antibiotic treatment or a program with short courses of antibiotics at the start of your urinary symptoms
  • Home urine tests, in which you dip a test stick into a urine sample, to check for infection
  • A single dose of antibiotic after sexual intercourse if your infections are related to sexual activity
  • Vaginal estrogen therapy if you're postmenopausal, to minimize your chance of recurrent UTIs
Severe infection
For a severe UTI, you may need treatment with intravenous antibiotics in a hospital.



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