In a healthy organism, the urinary system should be sterile, except for the opening of the urethra, through which microorganisms can enter and colonize other parts of the urinary system.
This problem concerns women much more often due to their anatomical structure. Children are also at increased risk of developing urinary tract infections due to birth defects. It is estimated that 40% of cases are nosocomial infections, and 10-20% outside of it.
The presence of microorganisms (bacteria, viruses, fungi) in the urinary tract located above the bladder sphincter.
The main pathogen of UTI, as many as 70-90% of cases, is the Escherichia coli bacterium. In contrast, in sexually active women, Staphylococcus saprophyticus. Fungi may also be responsible for urinary tract infection – Candida albicans, this most often applies to patients with diabetes and those using antibiotic therapies or immunosuppressants.
- Age – impaired prostate secretion, decreased estrogen production, urination disorders (congestion)
- Pregnancy – reduction of muscle tone of the ureters, pressure of the uterus on the ureters and bladder, glycosuria
- Catheterization and urological procedures
- Change of bacterial flora – antibiotic therapy, immunosuppressants
- Diabetes – glycosuria, microangiopathy, and neuropathy
- Retention of urine in the bladder
- Dysuria – pain, burning, discomfort when urinating
- Frequent or constant urge to urinate
- Haematuria (40%)
- Pain in the lower abdomen area
- In case of kidney infection – fever, pain in the kidney area, nausea, vomiting.
- In children – fever, irritability, lack of appetite, abdominal pain, vomiting
Prevention of recurrent UTIs:
- Drinking fluids -> increasing diuresis, more frequent micturitions (especially before intercourse)
- Proper hygiene
- Avoiding spermicides
- Cranberry juice -> weakening of bacterial adhesion to the epithelium
- Vaginal creams with estrogens -> after menopause, effectiveness has been called into question
- Vaginal preparations with Lactobacillus (probiotic)
Immunoprophylaxis -> freeze-dried coli
Antibiotic therapy is the mainstay of treatment of urinary tract infections. It is essential nowadays to use a targeted drug. Therefore, it is necessary to perform a bacteriological urine examination and an interview with the patient. In adults, in acute uncomplicated and recurrent cystitis, the most commonly used are: FURAZIDIN, KOTRIMAZOL, FOSFOMYCIN. Second choice drugs are: fluoroquinolones, amoxicillin + clavulanic acid.
- Ostrowska, A. Strzelczyk, A. Różalski, P. Stączek, Bacterial biofilm as a cause of urinary tract infections – pathogenic microorganisms, methods of prevention and eradication,
- Szczeklik, P. Gajewsk, Interna Szczeklik,
- Janiec, Pharmakodynamics, vol. 2, a textbook for Students of Pharmacy