Written by Ms. Madeline
OVERVIEW OF URINARY TRACT INFECTION
Mustafa et al found that 9.6% of hospitalized patients in Sabah General Hospital had urinary tract infection, which is similar to prevalence reported by other countries. Our urinary system involves kidneys, ureters, bladder and urethra. However, female has shorter urethra compared to male thus increasing the risk of female having urinary tract infection. The infection usually involves lower urinary tract which is bladder (cystitis) and urethra (urethritis).
However, the bacteria may also travel up to kidneys and causes acute pyelonephritis (rare, about 28 cases per 10,000 women per annum). The most common organism that causes UTI is Escherichia Coli (80-85%). Other possible pathogens include Staphylococcus saprophyticus (5-15%), Klebsiella species, Proteus, Pseudomonas aeruginosa, Candida, Enterococci etc.
SIGNS AND SYMPTOMS OF UTI
Lower UTI (Cystitis/Urethritis)
1. Urgency- need to rush to toilet urgently
2. Frequency- need to urinate very frequently
3. Incomplete urination
4. Burning sensation during urination
5. Cloudy urine
6. Foul smell urine
7. Blood in urine- may be red, bright pink or cola-colored
8. Pelvic pain (in female)
9. Discharge
Upper UTI (Pyelonephritis)
1. Same as LOWER UTI
2. High fever with chills
3. Upper back and side pain
4. Nausea and vomiting
RISK FACTOR
- Female has higher prevalence compared to male (50-80% more incidences) but mostly uncomplicated cystitis
- Diabetes
- Kidney stone
- Pregnancy
- Postmenopausal changes
- Urinary catheterization
- Sexual intercourse
TREATMENT
Usually need a course of antibiotic to get rid of the bacterial infection. Advisable to seek physician’s help if having signs and symptoms as above.
PREVENTION
- Sufficient intake of fluid per day (2-3L per day)
- Urinate frequently after intercourse (especially female)
- Urinate once there is an urge to do so
- Practice good genital and urinary hygiene
- Avoid extremely tight-fitting pants
- Avoid multiple sex partners
- Choose sanitary pads over tampons
- Unsweetened cranberry juice
- Cranberry extract supplement
- Probiotic (Lactobacillus strain)
- Bearberry/Uva-ursi supplement
- https://www.nzgp-webdirectory.co.nz/WEB+DIRECTORY/RENAL/Urinary+Tract+-+Female+and+Male.html
- Murtaza Mustafa, Jaistin Tamin, Joseph Balingi. Urinary Tract Infections in a Sabah General Hospital. IOSRJPBS. 2012 July-August;1(6):44-48
- Vasudevan R. Urinary tract infection: an overview of the infection and the associated risk factors. J Microbiol Exp. 2014;1(2):42‒54. DOI: 10.15406/jmen.2014.01.00008
- Dr Anita Bhajan Manocha. Urinary Tract Infection [Internet]. 2012 April 26 [Cited 2019 June 26]. Available from: http://www.myhealth.gov.my/en/prime-years-urinary-tract-infection/
- Dr Milton Lum. Managing Urinary Tract Infections. The Star Online [Internet]. 2010 Aug 4 [Cited 2019 June 26]. Available from: https://www.thestar.com.my/lifestyle/health/2010/08/04/managing-urinary-tract-infections/
- Mayo Clinic. Urinary Tract Infection (UTI) [Internet]. 2019 Jan 30 [Cited 2019 June 26]. Available from: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447 & https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453
- Rachael Link. 6 Home Remedies for Urinary Tract Infections [Internet]. 2017 April 23 [Cited 2019 June 26]. Available from: https://www.healthline.com/nutrition/uti-home-remedies#section1
- Akgül T, Karakan T. The role of probiotics in women with recurrent urinary tract infections. Turk J Urol 2018; 44(5): 377-83.