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Urinary tract infection - adults
Bladder infection - adults; UTI - adults; Cystitis - bacterial - adults; Pyelonephritis - adults; Kidney infection - adults
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including:
-
Bladder. An infection in the bladder is also called
cystitis
or a bladder infection.
Cystitis
Acute cystitis is an infection of the bladder or lower urinary tract. Acute means that the infection begins suddenly.
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Kidneys. An infection of one or both kidneys is called
pyelonephritis
or a kidney infection.
Pyelonephritis
Reflux nephropathy is a condition in which the kidneys are damaged by the backward flow of urine into the kidney.
ImageRead Article Now Book Mark Article - Ureters. The tubes that take urine from each kidney to the bladder are rarely the only site of infection.
-
Urethra. An infection of the tube that empties urine from the bladder to the outside is called
urethritis
.
Urethritis
Urethritis is inflammation (swelling and irritation) of the urethra. The urethra is the tube that carries urine from the body.
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Causes
Most UTIs are caused by bacteria that enter the urethra and then the bladder. The infection most commonly develops in the bladder, but 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.
The following also increase your chances of developing a UTI:
- Diabetes
-
Advanced age and conditions that affect personal care habits (such as
Alzheimer disease
and
delirium
)
Alzheimer disease
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer disease is one form of dementia. It affects memory, thinking, and...
ImageRead Article Now Book Mark ArticleDelirium
Delirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.
ImageRead Article Now Book Mark Article - Problems emptying the bladder completely
-
Having a urinary catheter
Having a urinary catheter
A catheter is a tube in your bladder that removes urine from the body. This tube may stay in place for an extended period of time. If so, it is cal...
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Bowel incontinence
Bowel incontinence
Bowel incontinence is the loss of bowel control, causing you to pass stool unexpectedly. This can range from sometimes leaking a small amount of sto...
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Enlarged prostate
,
narrowed urethra
, or anything that blocks the flow of urine
Enlarged prostate
The prostate is a gland that produces the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through wh...
ImageRead Article Now Book Mark ArticleNarrowed urethra
Urethral stricture is an abnormal narrowing of the urethra. Urethra is the tube that carries urine out of the body from the bladder.
ImageRead Article Now Book Mark Article - Kidney stones
- Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture)
- Pregnancy
- Surgery or other procedure involving the urinary tract
Symptoms
The symptoms of a bladder infection include:
-
Cloudy
or bloody urine, which may have a foul or strong odor
Cloudy
Blood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...
ImageRead Article Now Book Mark Article - Low fever in some people
- Pain or burning with urination
- Pressure or cramping in the lower abdomen or back
- Strong need to urinate often, even right after the bladder has been emptied
If the infection spreads to your kidneys, symptoms may include:
- Chills and shaking or night sweats
- Fatigue and a general ill feeling
- Fever above 101°F (38.3°C)
- Pain in the side, back, or groin
- Flushed, warm, or reddened skin
-
Mental changes or
confusion
(in older people, these symptoms often are the only signs of a UTI)
Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
ImageRead Article Now Book Mark Article - Nausea and vomiting
- Very bad abdominal pain (sometimes)
Exams and Tests
Most of the time you will need to provide a urine sample for the following tests:
-
Urinalysis
. This test is done to look for white blood cells, red blood cells, bacteria, and to test chemicals such as nitrites in the urine. This test can diagnose an infection most of the time.
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Clean-catch urine culture
. This test may be done to identify the bacteria and determine the best antibiotic for treatment.
Clean-catch urine culture
A urine culture is a lab test to check for bacteria or other germs in a urine sample. It can be used to check for a urinary tract infection in adults...
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Blood tests such as complete blood count ( CBC ) and a blood culture may be done as well.
CBC
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
You may also need the following tests to help rule out other problems in your urinary system:
-
CT scan of the abdomen
CT scan of the abdomen
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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Intravenous pyelogram
(IVP)
Intravenous pyelogram
An intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...
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Kidney scan
Kidney scan
A renal scan is a nuclear medicine exam in which a small amount of radioactive material (radioisotope) is used to measure the function of the kidneys...
ImageRead Article Now Book Mark Article - Kidney ultrasound
-
Voiding cystourethrogram
Voiding cystourethrogram
A voiding cystourethrogram is an x-ray study of the bladder and urethra. It is done while the bladder is emptying.
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Treatment
Your health care provider must first decide if the infection is just in the bladder, or if it has spread to the kidneys and how severe it is.
MILD BLADDER AND KIDNEY INFECTIONS
- Most of the time you will need to take an antibiotic to prevent the infection from spreading to the kidneys.
- For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 to 14 days (men).
- If you are pregnant or have diabetes, or have a mild kidney infection, you will most often take antibiotics for 7 to 14 days.
- Finish all of the antibiotics, even if you feel better. If you do not finish the whole dose of medicine, the infection may return and be harder to treat later.
- Always drink plenty of water when you have a bladder or kidney infection.
- Tell your provider if you might be pregnant before taking these drugs.
RECURRENT BLADDER INFECTIONS
Some women have repeated bladder infections. Your provider may suggest that you:
- Take a single dose of an antibiotic after sexual contact to prevent an infection.
- Have a 3-day course of antibiotics at home to use if you develop an infection.
- Take a single, daily dose of an antibiotic to prevent infections.
MORE SEVERE KIDNEY INFECTIONS
You may need to go into the hospital if you are very sick and cannot take medicines by mouth or drink enough fluids. You may also be admitted to the hospital if you:
- Are an older adult
- Have kidney stones or changes in the anatomy of your urinary tract
- Have recently had urinary tract surgery
- Have cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems
- Are pregnant and have a fever or are otherwise ill
At the hospital, you will receive fluids and antibiotics through a vein.
Some people have UTIs that do not go away with treatment or keep coming back. These are called chronic UTIs. If you have a chronic UTI, you may need stronger antibiotics or to take medicine for a longer time.
You may need surgery if the infection is caused by a problem with the structure of the urinary tract.
Outlook (Prognosis)
Most UTIs can be cured. Bladder infection symptoms most often go away within 24 to 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for symptoms to go away.
Possible Complications
Complications may include:
-
Life-threatening blood infection (
sepsis
). The risk is greater among the young, very old adults, and those whose bodies cannot fight infections (for example, due to HIV or cancer chemotherapy).
Sepsis
Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.
ImageRead Article Now Book Mark Article - Kidney damage or scarring.
- Kidney infection.
When to Contact a Medical Professional
Contact your provider if you have symptoms of a UTI. Call right away if you have signs of a possible kidney infection, such as:
- Back or side pain
- Chills
- Fever
- Vomiting
Also call if UTI symptoms come back shortly after you have been treated with antibiotics.
Prevention
Diet and lifestyle changes may help prevent some UTIs. After menopause, a woman may use estrogen cream around the vagina to reduce infections.
Lifestyle changes
Most urinary tract infections (UTIs) are caused by bacteria that enter the urethra and travel to the bladder. This can lead to infection. Most ofte...
References
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;52(5):e103-e120. PMID: 21292654 www.ncbi.nlm.nih.gov/pubmed/21292654 .
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;50(5):625-663. PMID: 20175247 www.ncbi.nlm.nih.gov/pubmed/20175247 .
Hooton TM. Nosocomial urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 304.
Sobel JD, Kaye D. Urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 74.
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Urinary tract infection - adults
Animation
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Bladder catheterization, female - illustration
A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time.
Bladder catheterization, female
illustration
-
Bladder catheterization, male - illustration
Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.
Bladder catheterization, male
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Prevention of cystitis - illustration
Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra. Females are especially vulnerable to this, because the urethra is in close proximity to the rectum. The genitals should be cleaned and wiped from front to back to reduce the chance of dragging E. coli bacteria from the rectal area to the urethra.
Prevention of cystitis
illustration
-
Bladder catheterization, female - illustration
A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time.
Bladder catheterization, female
illustration
-
Bladder catheterization, male - illustration
Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.
Bladder catheterization, male
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Prevention of cystitis - illustration
Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra. Females are especially vulnerable to this, because the urethra is in close proximity to the rectum. The genitals should be cleaned and wiped from front to back to reduce the chance of dragging E. coli bacteria from the rectal area to the urethra.
Prevention of cystitis
illustration
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Urinary tract infection in women
(Alt. Medicine)
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Urinary tract infection
(In-Depth)
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Urinary incontinence
(In-Depth)
-
Kidney stones
(In-Depth)
-
Benign prostatic hyperplasia
(Alt. Medicine)
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Herpes simplex
(In-Depth)
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Vitamins
(In-Depth)
-
Gallstones and gallbladder disease
(In-Depth)
-
Diabetes - type 2
(In-Depth)
-
Crohn disease
(In-Depth)
Review Date: 9/26/2015
Reviewed By: Daniel N. Sacks MD, FACOG, obstetrics & gynecology in private practice, West Palm Beach, FL. Review Provided by VeriMed Healthcare Network. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
