Urinary Tract Infection – Causes, Symptoms and Treatment
Urinary tract infection
Every year, a huge number of patients, both adults, and children, regardless of gender, face such a serious medical problem as a urinary tract infection. Women suffer from this infection much more often than men, but men with the development of urinary tract infections expect a tendency to a protracted and even severe course of the disease.
Urinary tract infections are inflammatory diseases of the urinary system of a person caused by infectious microorganisms that have a recurring course with possible complications.
The urinary tract (urinary tract) is a single set of organs for the formation of urine and its excretion from the body, this is a serious system of isolation, from the clear functioning of which depends not only on the state of the human body but also the patient’s life in some cases (with acute renal failure). Urinary tracts are formed from buds of the bean-shaped form (urine is formed in them), ureters (urine enters the bladder through them), urinary bladder (urine reservoir), urethra or urethra (urine release outwards).
Urinary tracts play an important role in maintaining the water-salt balance of the body, the production of a number of hormones (erythropoietin, for example), the release of a number of toxic substances from the body. For a day on average, up to 1.5-1.7 liters of urine is released, the amount of which can vary depending on the fluid, salt, urinary tract diseases.
Risk groups for urinary tract infection:
- Female sex (women suffer from such infections 5 times more often than men, this is due to the physiological characteristics of the woman’s body – a short and wide urethra, which makes infection easier to enter the urinary tract).
- Children up to 3 years of age (inferior immunity, in particular, infections of the excreting system are the most frequent cause of fever of unknown origin among boys up to 3 years old).
- The elderly due to the development of age-related immunodeficiency.
- Patients with structural features of the urinary system (for example, an enlarged prostate gland may obstruct the flow of urine from the bladder).
- Patients with renal pathology (for example, urolithiasis, in which stones are an additional risk factor for the development of infections).
- Resuscitation and intensive care patients (such patients are required for any period of time to urinate with a urinary catheter – this is the entrance gate of the infection).
- Patients with chronic diseases (for example, diabetes mellitus, in which there is a high risk of urinary tract infections by reducing the body’s resistance).
- Women who use some methods of contraception (for example, diaphragmatic ring).
Factors predisposing to the occurrence of urinary tract infection are:
- supercooling (the bulk of problems of this nature occurs during the cool season),
- the presence of respiratory infection in the patient (frequent activation of urological
infections during the cold season),
- decreased immunity,
- disturbed urine outflow of various types.
Causes of urinary tract infection
In the kidneys, the urine is absolutely sterile from microorganisms, it contains only water, salts, and various metabolic products. The infectious agent first penetrates into the urethra, where favorable conditions for its reproduction are created – urethritis develops. Further spreads higher to the bladder, in which inflammation of its mucosa occurs – cystitis. In the absence of adequate treatment, the ureters get the infection in the kidneys with the development of pyelonephritis. This is the most frequent ascending type of infection.
Pathogens causing urinary tract infection:
1) E. coli (Escherichia coli). This causative agent is a representative of the normal flora of the colon, and getting it into the urethra is mainly due to non-observance of the rules of personal hygiene. Also, the E. coli is almost always present on the external genitalia. 90% of all urinary tract infections are associated with the E. coli.
2) Chlamydia and mycoplasmas are microorganisms that affect mainly the urethra and ducts of the reproductive system. They are transmitted mainly through sexual contact and affect the genitourinary system.
3) Klebsiella, Pseudomonas aeruginosa may be the causative agent of urinary tract infections in children.
4) Periodically there are streptococcus serogroups A and B.
How can microorganisms get into the urinary tract:
1) If the rules of personal hygiene are not respected after visiting the toilet room.
2) During sexual intercourse and anal sex.
3) When using certain methods of contraception (diaphragmatic ring, spermicide).
4) Children have inflammatory changes due to stagnation of urine in the pathology of urinary tracts of various types.
Symptoms of urinary tract infection
What clinical forms of urinary tract infections occur in medical practice? It is an infection of the urethra or urethra – a urethritis; infection of the bladder – cystitis; infection and inflammation in the kidneys – pyelonephritis.
There are also two main types of infection spread – an ascending infection and a descending infection. With an ascending infection, the inflammatory process affects the organs of the urinary system located anatomically below, and then the infection spreads to the upper organs. An example is cystitis and the subsequent development of pyelonephritis. One of the causes of ascending infection is the so-called problem of a functional nature in the form of vesicoureteral reflux, which is characterized by a reverse urine flow from the bladder to the ureters and even the kidneys. Descending infection by origin is more understandable. In this case, the pathogen spreads from the higher located parts of the urinary system to lower ones, for example, from the kidneys to the bladder.
Many cases of infectious diseases of the urinary system are asymptomatic. But still, for specific clinical forms, there are certain symptoms, which patients most often complain about. For most patients, nonspecific symptoms are typical: weakness, poor health, overwork, irritability. This symptom as causeless at first glance fever (temperature) – in the vast majority of cases, a sign of the inflammatory process in the kidneys.
When urethritis patients are concerned: during urination, pain and burning at the beginning of the process of urination, discharge from the urethra mucopurulent, having a specific odor.
With cystitis, frequent urination occurs, which can be painful, accompanied by painful sensations in the lower abdomen, a feeling of insufficient emptying of the bladder, and sometimes the temperature may rise.
Pyelonephritis is characterized by the appearance of pain in the lumbar region, an increase in body temperature (with the acute process), chills, symptoms of intoxication (weakness, body aches), and the patient may not feel urinary disorders. Only with an ascending infection can disturb first the pain when urinating, frequent urination.
Summarizing the above, we list the symptoms characteristic of infections of the urogenital tract, requiring treatment to the doctor:
1) pain, burning and rubbing when urinating;
2) frequent urination;
3) pain in the lower abdomen, in the lumbar region;
4) pain in the suprapubic region in women;
5) the temperature and symptoms of intoxication without the appearance of colds;
6) discharge from the urethra mucopurulent;
7) a change in the color of urine – becomes turbid, the appearance of mucus, flakes, veins of blood;
Features of urinary tract infection in children
Common causes of urinary tract infections in children are obstruction of the urogenital tract, various functional disorders, phimosis, congenital anomalies of the urinary tract, and rare bladder emptying.
Symptoms of urinary tract infection in babies can be erased. Children under 1.5 years with such infection can become irritable, crying, refuse to eat, may not be very high, but unreasonable temperature, poorly doped with conventional antipyretic drugs. Only from the age of two, the child complains of pains in the abdomen or back, pain in the lower abdomen, you will notice frequent urination, urination disorders, body temperature often rises, rather than remains normal.
The outcome of urinary tract infection in a child is often favorable, but there are such consequences as sclerosis of kidney tissue, arterial hypertension, protein in the urine, functional kidney disorders.
Features of urinary tract infection in pregnant women
Up to 5% of pregnant women suffer from inflammatory diseases of the kidneys. The main reasons for this include hormonal changes in the body during pregnancy, a decrease in immunological defense of the body, a change in the location of certain organs associated with the growing fetus. For example, due to the increase in the size of the uterus, there is pressure on the bladder, stagnation occurs in the urinary organs, which will eventually lead to the multiplication of microorganisms. Such changes require frequent monitoring of this system in a pregnant woman.
Features of urinary tract infection in men
First of all, the causes leading to the occurrence of urinary tract infections in men differ from those of women. This is basically a pathology like urolithiasis and an increase in the size of the prostate gland. Hence the disturbed outflow of urine and inflammatory changes in the urinary system. In the treatment of men in this regard, such an item is included as removing the obstruction to urinary outflow (stone, for example). Also, certain problems cause a chronic inflammatory process in the prostate gland, which requires massive antibiotic therapy.
Diagnosis of urinary tract infection
Preliminary diagnosis is made on the basis of clinical complaints of the patient, but not in all cases it is enough to make the right diagnosis. For example, pyelonephritis can be accompanied only by the temperature and symptoms of intoxication, pain in the lower back does not appear in the first day of the disease. Therefore, without additional laboratory methods of research, the doctor is difficult to diagnose.
Laboratory diagnostics include:
1) general clinical tests: general blood test, general urine analysis, biochemical blood tests (urea, creatinine) and urine (diastase).
The most informative at the initial stage is the general analysis of urine. For the study, the average portion of the morning urine is taken. The study counts the number of leukocytes, erythrocytes, so you can suspect bacteriuria (bacterial inflammatory process). Also informative are such indicators as protein, sugar, specific gravity.
2) bacteriological method (sowing urine on special nutrient media in order to detect the growth of certain microorganisms in them), in which the average portion of morning urine is taken into sterile dishes;
3) PCR method (with negative baptize and continuing infection of the urinary tract) – to identify such microorganisms as chlamydia, mycoplasma.
4) Instrumental diagnostic methods: ultrasound of the kidneys and bladder, cystoscopy, radiocontrast study or intravenous urography, radionuclide studies and others.
Basic principles of treatment of urinary tract infection
1. Regimens: home half-bed treatment regimen for infections of the urinary system, and according to the indications, hospitalization in the therapeutic or urological department of the hospital. Compliance diet regime with the restriction of salt and a sufficient amount of fluid in the absence of kidney failure.
2. Etiotropic treatment (antibacterial) includes various groups of drugs that are
prescribed ONLY by the doctor after the correct diagnosis. SELFINATION will lead to the formation of antibiotic resistance to the pathogen of infection and the occurrence of frequent recurrences of the disease. For treatment, apply trimethoprim, Bactrim, amoxicillin, nitrofurans, ampicillin, fluoroquinolones (ofloxacin, ciprofloxacin, norfloxacin), if necessary, combinations of drugs. The course of treatment should be 1-2 weeks, less often longer (with concomitant pathology, the development of septic complications, anomalies of the urinary system). After the end of treatment, it is mandatory to monitor the effectiveness of the treatment with a complete laboratory examination, appointed by the attending physician.
Running cases of urinary tract infections with the formation of a protracted course sometimes require longer courses of etiotropic treatment with a total duration of several months.
Recommendations of the doctor for the prevention of protracted urinary tract infection:
– drinking regimen (sufficient fluid intake during the day);
– timely evacuation of the bladder;
– hygiene of the crotch area, daily shower instead of taking a bath;
– thorough hygiene after sexual intercourse;
– not allow self-medication with antibiotics;
– avoid sharp and salty foods, taking coffee;
– Drink cranberry juice;
– Cut down sharply until completely eliminated smoking;
– avoid sexual intercourse during the treatment period;
– Exclude alcohol.
Features of therapeutic measures in pregnant women:
When registering urinary tract infections in pregnant women, treatment is carried out without delay to prevent more serious problems (premature birth, toxicosis, hypertension). The choice of an antibacterial drug remains with the doctor and depends on the period of pregnancy, evaluation of its effectiveness and possible risks to the fetus. Prescription of drugs is strictly individual.
3.Posidromalnaya therapy (febrifuge at a temperature, urological fees, herbal uroseptics,
for example, photolysis, immunomodulators and others).
4. Phytotherapy for urinary tract infections: apply herbal extracts (birch leaves, bearberry, horsetail grass, dandelion root, juniper fruit, fennel fruits, black elderberry, parsley, chamomile flowers and others).
The main problem of urinary tract infections is the frequent development of a recurrent form of infection. This problem is typical for women, every 5th woman after the initial debut of a urinary tract infection meets with the repetition of all the symptoms, that is, the development of relapse, and sometimes of frequent relapses. One of the important properties of relapses is the formation of new mutated strains of microorganisms with an increase in the frequency of relapses. These mutated strains of bacteria already acquire resistance to specific drugs, which, of course, will affect the quality of treatment of subsequent exacerbations of the infection.
Recurrences of urinary tract infection can be related to:
1) with an incomplete primary infection (due to improper low doses of antibacterial drugs, non-adherence to the treatment regimen, development of drug resistance to drugs);
2) with a long persistence of the pathogen (the ability of the pathogen to attach to the mucous membrane of the urinary tract and stay in the source of infection for a long time);
3) with the emergence of a re-infection (reinfection with a new causative agent of the periurethral space, direct bilge, skin of the perineum).
Prevention of urinary tract infection
1) Important in preventive measures is the timely sanation of chronic foci of bacterial
infection (tonsillitis, maxillary sinusitis, cholecystitis, dental caries and others), from which the infection can spread with the bloodstream and affect the urinary system.
2) Observance of hygienic rules for care of intimate zones, especially girls and women,
3) Avoid overwork, hypothermia of the body.
4) Timely correction of changes in the human immune system.
5) Timely treatment of diseases of the urinary system (urolithiasis, prostatitis, developmental anomalies).