Urinary tract infection

Urinary tract infections (UTIs) are common bacterial infections with 5% of women having symptoms every year and 3% of girls and 1% of boys having a UTI before the age of 11.

UTIs can cause a range of illness from mild inflammation of the bladder to severe infections of the kidney but are generally treatable with antibiotics.

What is a UTI?

As the name suggests it is an infection of the urinary tract which consists of the kidneys, bladder and the tubes which transport urine between the two and out of the body (ureters and urethra).

UTIs are almost always caused by bacteria, most commonly E. coli from the patients' own bowels.

Who is affected?

UTIs are far more common in women than in men until the age of 60 when the incidence becomes similar for both sexes.

In men a UTI is mostly associated with an underlying cause such as an enlarged prostate gland.

Infections can also occur in hospital due to use of catheters.

What are the symptoms?

Symptoms include burning on passing urine and the sensation of needing to pass urine frequently, fever, shivers, and pain in the abdomen.

The urine may also be cloudy with an offensive smell.

In younger children and babies, there may not be an obvious specific symptoms - they can simply appear feverish, irritable or drowsy, be off their food or have vomiting or diarrhoea.

How are UTIs diagnosed?

The doctor can use a test strip in a sample of urine to look for signs of infection but a sample is also sent to the laboratory to assess the level of infection and to check what treatment the infection is sensitive to.

In people who suffer recurrent infections the doctor will need to check for the underlying cause.

Up to 50% of causes are caused by some form of structural abnormality that predisposes a person to infection.

Other causes include not going to the toilet often enough and damage to the bladder nerves.

In children UTIs need to be thoroughly investigated as scarring of the urinary tract can lead to long-term problems.

This means they will be sent for an ultrasound or a specialised X-ray.

What is the treatment?

The mainstay of treatment is antibiotics, such as trimethoprim or nitrofurantoin.

The type of antibiotic depends on the results of the laboratory test and whether the infection is a mild lower UTI or more serious upper UTI.

Patients will also need to drink a high volume of fluids to flush out the system.

With severe cases or infections in small babies, hospitalisation may be necessary.

Some people also find drinking cranberry juice may help if they get frequent infections.