Urinary Tract Infection in Females
An uncomplicated urinary tract infection (UTI) is a bacterial infection that primarily affects the bladder and nearby structures. It occurs in individuals who do not have structural abnormalities of the urinary tract or underlying health conditions such as diabetes, immunosuppression, recent urologic surgery, or pregnancy. This type of infection is also known as cystitis or a lower urinary tract infection.
Urinary tract infections (UTIs) are more common in women than in men, primarily due to anatomical factors. The female urethra is relatively short—about 3 to 4 cm in length—and is located close to the vagina, anus, and rectum. This proximity increases the risk of bacterial entry into the urinary tract, making women more susceptible to infection.
Types of UTI
- Uncomplicated
- Complicated
An uncomplicated urinary tract infection (UTI)—also referred to as a simple UTI, cystitis, or lower tract UTI—is a bacterial infection confined to the lower urinary tract in an otherwise healthy individual. These infections are generally more common and easier to treat than complicated UTIs.
A complicated urinary tract infection (UTI) is a broad term that includes all infections that do not meet the criteria for being uncomplicated. UTIs in men, pregnant women, immunocompromised individuals, or patients with structural or functional abnormalities of the urinary tract are classified as complicated infections.
Pathophysiology
Most urinary tract infections (UTIs) are caused by bacteria from the Enterobacteriaceae family, particularly Escherichia coli, Klebsiella species, and Enterobacter species. Together, these organisms are responsible for approximately 90% of UTIs that occur during pregnancy.
Symptoms of UTI
- Urinary burning
- Urgency
- Frequency
- Lower abdominal discomfort
- Bloody urine
- Fevers, frequently associated with upper UTI
Diagnosis
The diagnosis of a urinary tract infection (UTI) is primarily guided by the patient’s clinical history and supported by urinalysis. Confirmation is established through a urine culture. Accurate results depend on proper collection of the urine sample, as contamination can lead to misleading findings.
Diagnostic studies for UTI consist of dipstick, urinalysis, and culture.
UTI in Pregnancy
Urinary tract infections (UTIs) are relatively common during pregnancy and can pose significant risks for both the mother and fetus. If bacteriuria is left untreated, up to 25% of women may develop acute pyelonephritis. This condition can lead to serious complications, including preterm labor and transient renal failure.
Prevalence
Urinary tract infections (UTIs) occur far more commonly in women. 20% of women suffer from at least one UTI in their lifetime which include upper UTI or lower UTI. The prevalence of UTIs is usually higher in females than males and observed frequently in the middle age groups (21-40 years).
Treatment
For Urinary tract infections (UTI), Nitrofurantoin and Fosfomycin have good efficacy and are suitable for treatment. E. coli is the most frequent bacteria causing urinary infections. Better consult with your physician before intake.
Dose of Drugs
1- Nitrofurantoin monohydrate/macrocrystals (twice daily for 14 days)
2- Fosfomycin (single 3g dose)
Case Study
Mrs. M, an 87-year-old resident of a nursing home, was referred to the community ANP by the senior carer. The main concern reported was dark, cloudy, and foul-smelling urine. According to the National Institute for Health and Care Excellence (NICE, 2021), cloudy and foul-smelling urine may be a sign of a urinary tract infection (UTI). Other possible symptoms include increased frequency or urgency to urinate, painful urination (dysuria), blood in the urine (haematuria), dark-colored urine, mild fever, nocturnal urination, excessive sweating or chills, and lower abdominal pain, which may indicate a more severe infection.
