A urinary tract infection (UTI) can be painful and nagging, but did you know that an untreated UTI can lead to a bladder or kidney infection? The urinary system consists of the urethra, the bladder, the ureters, and the kidneys. All of these pieces work together to help the body eliminate waste.
The kidneys' roles include filtering blood, removing toxins, regulating fluids, and maintaining electrolyte balance and other essential body components. After the kidneys filter the blood, the excess waste passes through the ureters, is stored in the bladder, and is ultimately expelled from the body when an individual urinates through the urethra. The urinary system is a vital and delicate system that is vulnerable to infection, which can cause serious harm.
What is a Urinary Tract Infection?
A UTI occurs when bacteria from the outside world enter the urethra and an infection develops. This foreign bacteria most often comes from fecal matter or vaginal flora. Approximately 80% of UTIs are caused by the bacteria Escherichia Coli. Anything that introduces bacteria into the urethra can lead to a UTI. There are factors that increase your chances of developing a UTI, such as:
- Recent sexual activity
- Poor urinary hygiene
- Catheterization
- History of recurrent UTIs
- Recent antibiotic use
- Dehydration
- Soaking in the bath (bacteria in the water can enter the urethra)
Some individuals may be more prone to recurrent UTIs because of underlying conditions or anatomy. Women are more likely to acquire UTIs because of the short length of the urethra compared to men. If a UTI is left untreated, the bacteria can ascend the urinary system, thus infecting the bladder, kidneys, or even the bloodstream.
What Symptoms Should I Be Aware Of?
Being aware of the symptoms of UTIs, bladder infections, kidney infections, and sepsis can help in the early detection of these infections. Medical care can be sought in a more timely manner to prevent the further spread of the infection. As an infection progresses from a UTI to an infection of the bladder or kidneys, the symptoms are more significant and more worrisome.
Symptoms of a UTI:
An infection of the urethra is typically the most common of all the infections discussed. The urethra is the most external part of the urinary system and is therefore more prone to bacterial exposure. Below are some UTI symptoms to look for:
- Pain (dysuria) or burning sensation during urination
- Urgency: The sensation of having to urinate that comes on suddenly and intensely
- Frequency: Having to urinate often, but sometimes there is not much urine to eliminate
- Altered mental status: Confusion or altered mental status is more common in older adults. Some older adults may only present with changes in mental status with a UTI. It is important to be aware of this when caring for older adults.
Symptoms of Cystitis (Bladder Infection):
An infection that was once in the urethra and considered a UTI can become a bladder infection as bacteria migrate. Symptoms of cystitis to be aware of include:
- Blood in the urine (hematuria)
- Urinary frequency
- Urinary urgency
- Painful urination
- Suprapubic pain (pain above the pubic bone where the bladder is located)
Symptoms of Pyelonephritis (Kidney Infection):
Bacteria left untreated in the bladder can ascend to the ureters and infect the kidneys. The kidneys are the organs responsible for filtering blood. Infection of this degree can lead to serious complications if left untreated. You may notice the following symptoms:
- Flank pain (pain of the lower back where the kidneys are located)
- Nausea and vomiting
- Fever
- Blood in the urine
- Chills
Symptoms of Sepsis
If an infection progresses without treatment, the result can be sepsis. Sepsis is when bacteria enter the bloodstream and thus infect the organs and ultimately the whole body. Sepsis is life-threatening and must be treated immediately, or it can result in death. Symptoms of sepsis can vary as the body attempts to fight the infection, and ultimately decline as it is overwhelmed by the foreign contaminant. Symptoms of sepsis due to a urinary system infection may include, but are not limited to:
- Fever
- Worsening urinary infection symptoms
- Blood pressure changes
- Increased heart rate
- Altered mental state
- Sweating
- Abnormal blood results
How Can I Prevent Getting a UTI?
There are many measures that can be taken to decrease your chances of contracting a UTI. Many of them are simple, yet significant. Below are some recommendations for preventing a UTI.
Stay hydrated: Drinking fluids helps flush unwanted bacteria from the body. When there is less fluid available, it is more likely that bacteria will prevail and continue to reproduce.
Proper urinary hygiene: Regular cleaning and frequent showering can help wash the skin around the urethra and eliminate any bacteria that may be present externally. For women, because of the proximity of the anus to the urethra, it is best practice to wipe front to back so that fecal bacteria are not introduced into the urethra.
Urination after sexual activity: Urinating helps remove bacteria from the urethra that may have been introduced during sexual activity.
How Are These Infections Diagnosed?
In conjunction with assessing the symptoms present above, a healthcare provider will obtain a urine sample to run a urine culture test. A urine culture will reveal whether bacteria are present in the urine. They will also assess for pyuria, which is the presence of white blood cells or pus in urine, indicating the body's attempt to fight an infection. Hematuria (blood in the urine) is another indicator of damage caused by an infection and can contribute to determining a diagnosis. Urine cultures can be obtained by having an individual urinate in a specimen container. For those who are either unconscious or unable to provide a sample on their own, a sample may be obtained through catheterization. During catheterization, a tube is inserted into the urethra, and urine is collected. Performing a urine culture will provide more concrete evidence as to whether an infection is present in the urinary system.
Treatment of a UTI
UTIs, bladder infections, kidney infections, and sepsis often require antibiotics for treatment. Antibiotics target bacteria, not viruses, which is why they work for these types of infections. It is very important that antibiotics are taken as prescribed by your healthcare provider. Symptoms can often improve or resolve within a few days after starting the course of antibiotics. If this is the case, it is imperative that all the antibiotics are taken at the full dose and timeline prescribed.
When antibiotics are only taken partially, the bacteria can continue to thrive and become resistant to the antibiotics. This means that the bacteria learn how to avoid the specific antibiotic, and it will no longer be effective. This is dangerous and can make the bacteria more difficult to eliminate.
While recovering from the infection, stay hydrated by drinking lots of fluids and getting proper rest to allow your body to recover. Additional supportive medications and fluids may be required for those with more severe infections to decrease fever, maintain blood pressure in septic patients, and support the body as it fights off the infection. If upon completion of the antibiotic course, symptoms have not resolved or continue to persist, contact your healthcare provider for further assessment and treatment.
Treatment can often be done in an outpatient setting, but if the infection becomes severe enough, hospitalization may be necessary. Sepsis will always require inpatient hospitalization to provide the necessary treatments to fight off such a tremendous infection.
Final Thoughts on UTI Prevention and Care
UTIs are common, but if left untreated, they can lead to further infections of the urinary system and can potentially become life-threatening. It is essential to be aware of the symptoms of these infections and to adopt good hygiene practices to prevent them. If symptoms arise, seek medical attention quickly so that treatment can begin in a timely manner.
About the Author:
Rachel Pugmire is a registered nurse and freelance writer. She received her Bachelor of Science in Nursing in 2018, with a minor in gerontology. Her areas of expertise include emergency medicine, pediatrics, and pharmaceutical clinical trials. Medical writing has given her a platform to do what she is passionate about, which is educating patients, their families, and other healthcare professionals.
Rachel is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
