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Urinary tract infection - adults
A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. Urinary tract infections have different names, depending on what part of the urinary tract is infected.
Bladder infection - adults; UTI - adults; Cystitis - bacterial - adults; Pyelonephritis - adults; Kidney infection - adults
Causes, incidence, and risk factors
Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the kidneys.
Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.
Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.
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The following also increase your chances of developing a UTI:
The symptoms of a bladder infection include:
If the infection spreads to your kidneys, symptoms may include:
Signs and tests
A urine sample is usually collected to perform the following tests:
The following tests may be done to help rule out problems in your urinary system that might lead to infection or make a UTI harder to treat:
Your doctor must first decide whether you have a mild or simple bladder or kidney infection or an infection that is more serious.
MILD BLADDER AND KIDNEY INFECTIONS
Antibiotics taken by mouth are usually recommended because there is a risk that the infection can spread to the kidneys.
Commonly used antibiotics include trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline, and fluoroquinolones. Your doctor will also want to know whether you could be pregnant.
Your doctor may also recommend drugs to relieve the burning pain and urgent need to urinate. Phenazopyridine hydrochloride (Pyridium) is the most common of this type of drug. You will still need to take antibiotics.
Everyone with a bladder or kidney infection should drink plenty of fluids.
Some women have repeat or recurrent bladder infections. Your doctor may suggest several different ways of treating these.
See also: Catheter-associated UTI
MORE SEVERE KIDNEY INFECTIONS
If you are very sick and cannot take medicines by mouth or drink enough fluids, you may be admitted to the hospital. You may also be admitted to the hospital if you:
At the hospital, you will receive fluids and antibiotics through a vein.
Some people have urinary tract infections that keep coming back or that do not go away with treatment. Such infections are called chronic UTIs. If you have a chronic UTI, you may need antibiotics for many months, or stronger antibiotics.
If a structural (anatomical) problem is causing the infection, surgery may be recommended.
A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder infection usually disappear within 24 - 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for your symptoms to go away.
Calling your health care provider
Contact your health care provider if you have symptoms of a UTI. Call right away if the following symptoms develop:
These may be signs of a possible kidney infection.
Also call if you have already been diagnosed with a UTI and the symptoms come back shortly after treatment with antibiotics.
Lifestyle changes may help prevent some UTIs.
After menopause, a woman may use estrogen cream in the vagina area to reduce the chance of further infections.
BATHING AND HYGIENE
Lin K, Fajardo K; U.S. Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2008 Jul 1;149(1):W20-4.
Little P, Moore MV, Turner S, et al. Effectiveness of five different approaches in management of urinary tract infection: randomised controlled trial. BMJ. 2010 Feb 5;340:c199. doi: 10.1136/bmj.c199.
Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar;52(5):e103-20.
Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010 Mar 1;50(5):625-63.
Reviewed by:A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine (9/13/2011).
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