Mon. Wed. Fri. 11:00 am-3:00 pm EST
About 80 percent, urinary tract infection in adults is caused by a variety of pathogens, infectious bacteria normally present in the intestines, especially in the colon. Nearly all infections of the lower urinary tract are caused by a few strains of E. coli bacteria, called uropathogenic Escherichia coli (UPEC).
As a part of the gastrointestinal system, they do not belong in the urinary tract. These bacteria, however, have multiple little hairs called cilia that function like little feet that allow them to climb from the skin around the vagina, up the urinary tube (urethra), into the bladder.
If E. coli get into the bladder or the urethra, the body has ways of fighting them off. They include the obvious methods of simply flushing them out with the urine. But these bacteria have evolved ways of anchoring themselves to the cells of the urinary tract.
They take advantage of receptors naturally found on the cells of the mucosal lining there. These receptors are like molecular “docking bays” for substances, which the cells need for their normal growth and development.
E. coli use “grappling hooks”, called type I pili, to hook on to these receptors, and then to invade the cell. These pathogenic “grappling hooks” are composed of long, fibrous chains of a molecular “glue” called adhesin.
Once inside the cell, E. coli can live and reproduce in safety, shielded from many of the body’s defensive immune responses. In fact, they are so sophisticated that when the body detects that cells have been infected and activates the cell suicide program to destroy the bacteria, E. coli can actually flee the dying host cell before it is flushed out, and look for new cells to invade!
Unfortunately, E. coli bacteria return in as many as 30 percent of women apparently “cured” by antibiotics! The pathogens are able to survive an antibiotic treatment by reverting to an inactive state.
It is true that within several days of antibiotic treatment, the number of bacteria reproducing can drop to zero. Not all the bacteria are killed, though.
About 3 percent of the bacteria may be still present in a dormant state after treatment with Cipro (ciprofloxacin). About 7 percent may linger after treatment with Bactrim-Septra (trimethoprim-sulfamethoxazole).
Even after a month of antibiotic exposure, about 10 million of the original 1 billion bacteria may remain.
Newly identified, antibiotic-resistant strains of a common E. coli bacterium are contributing to an increase in relatively hard-to-treat bladder infections in women.
An analyzed strain, resistant to a popular two-drug combination (Bactrim-Septra), shows a pattern of resistance to multiple antibiotics and has genetic characteristics called “virulence factors” that increase its ability to infect the urinary tract.
Not much is known about how new strains of bacteria that infect the urinary tract arise and spread. So far, there is also no evidence that the new strains of E. coli are causing any increase in kidney infections or other serious complications.
It could be that these organism have been around forever and have now acquired resistance to several antibiotics. They could have been introduced, perhaps through contaminated food.
A variety of other Enterobacteriaceae and Gram-positive pathogens tend to remain limited to the urethra and reproductive system. Unlike E. coli, they are sexually transmitted. There pathogenic bacteria usually relate to urinary tract catheterization, instrumentation or surgery.
Staph aureus is present in up to 25 percent of healthy people. This type of bacterium is commonly found on the skin and hair as well as in the noses and throats of people and animals. It is a common cause of urinary tract infections among people with urinary tract catheterization. Staph aureus is also a known cause of nosocomial urinary tract infections that are acquired and contracted within a hospital environment. Transmission usually occurs via healthcare workers, patients, hospital equipment, or interventional procedures. Urinary tract is one of the most common sites of infection.
Unfortunately, there is an increasing incidence of multidrug-resistant (MDR) pathogens causing hospital-acquired infections. This rise can be explained by indiscriminate use of antibiotics and lacking hygiene measures, especially among medical staff. Methicillin-resistant Staphylococcus aureus (MRSA) is one the commonly seen multidrug-resistant pathogens. Although not considered to be a sexually transmitted infection, Staph aureus is something that can be passed from skin to skin contact.
This pathogen, a gram-positive, coagulase-negative bacterium, has been recognized as a common cause of urinary tract infections since the early 1970s. It is responsible for 5 to 15 percent cases of UTIs.
It is found in the urinary tract and genitals. This bacterium may be a cause of urinary tract infection, especially in persons with a weakened immune system. However, it can be sometimes picked up this during sex.
In hospital settings, this pathogen can ascend from the gut and cause a urinary tract infection or infect by means of a urinary catheter. In five percent of the population, Klebsiella pneumoniae resides in the gut (feces) and respiratory tract. Unlike E. coli, Klebsiella is also found in environmental reservoirs like sewers, soil and surface water.
Found in most healthy individuals, this gram-positive bacterium can cause a variety of hospital-acquired (nosocomial) infections of which urinary tract infections are the most common.
Urinary tract infections due to this bacterium generally occur as a complication of the presence of a foreign body such as a catheter in the urinary tract. They can also be due to an obstruction within the genitourinary system or after instrumentation or surgery on the urinary tract. At high risk for this infection are paraplegics. Also a frequent use of antibiotics may lead to P. aeruginosa infection.
Pseudomonas aeruginosa is a common bacterium found in soil, water, skin flora and most man-made environments. As an opportunistic pathogen of immunocompromised individuals vulnerable to infections, it typically infects the urinary tract.
P. aeruginosa appears to be among the most adherent of common urinary pathogens to the bladder uroepithelium. An infection can occur via an ascending or descending route.
It can also invade the bloodstream from the urinary tract. This route is the source of approximately 40 percent of P. aeruginosa infections.
This bacterium is the third leading cause of hospital-acquired urinary tract infections, accounting for approximately 12 percent of all infections of this type. They are usually related to urinary tract catheterization, instrumentation or surgery.
As a highly relevant opportunistic pathogen, P. aeruginosa has low antibiotic susceptibility. It is naturally resistant to a large range of antibiotics and may demonstrate additional resistance after unsuccessful treatment.
Therefore, choosing an antibiotic should be guided according to antibiotic susceptibility test (AST), rather than empirically. By exposing P. aeruginosa to a variety of antibiotics, it helps to decide which one should be prescribed for this particular infection.
Chlamydia is a common sexually transmitted disease caused by a bacterium called Chlamydia trachomatis. In men, the chlamydia organisms infect cells of the lining of urethra, rectum and eye.
People with chlamydia often have no symptoms. Consequently, they may transmit the infection to other people without knowing it.
However, when the symptoms do occur, their type and severity will depend on the site of the infection and the person’s response to it. In men, chlamydia most often causes urethritis, an inflammation of the urethra in the penis. The symptoms include:
To diagnose chlamydia, a special test must be done by a health professional. As this is a serious condition, it requires prompt medical attention and is easily treated with an antibiotic medication.
However, if it is not detected and treated, chlamydia infection can spread to the epididymis – a long, coiled tube that stores sperm and transports it from the testes. It may cause pain and swelling in the scrotum (epididymitis). If left untreated, acute epididymitis can lead to a range of complications.
Although the most common cause of epididymitis is chlamydia along with gonorrhea, it can also be caused by a non-sexually transmitted infection, such as a urinary tract infection or prostate infection.
Although 25 percent of all hospitalized patients will receive a catheter at some point in their stay, nearly 1 out of every 3 patients undergoing catheterization does not need it! That much of this overcatheterization may be due to the fact that it makes the jobs of hospital staff easier.
However, once inserted, the devices often remain too lon because doctors either forget or do not know which of their patients still have a catheter inserted.
Catheters are considered necessary for patients who are:
Unfortunately, every day a catheter is left in, a patient has a 5 percent chance of developing a urinary tract infection, as bacteria from the patient’s genital area – in most cases pathogenic E. coli bacteria – migrate up the outside of the catheter and infect the otherwise sterile bladder.
Usually treated with antibiotics, the urinary tract infections have the potential to lengthen hospital stays and cause more serious side effects that can be life threatening (when infection spreads to the bloodstream).
For this reason, researchers are calling for a mandatory “stop-order” on all hospital catheterizations after 48 hours, with a daily review thereafter. The incidence of UTIs is reduced, however, if silver alloy catheters are used.
Other causes of acute and/or chronic urinary tract infections include:
Unfortunately, cases of low-grade prostatitis are often missed on a doctor’s visit. Many men may experience no symptoms or symptoms so sudden and severe that they have to seek an emergency medical care. Both bladder infection and prostate infection should be treated thoroughly because of the chance of kidney infection (nephritis).