Wednesday, October 24, 2012

Some Urinary Tract Infection FAQs

What is a UTI?  UTI stands for urinary tract infection.  This implies symptoms of an infection in the face of a reliably positive urine culture. 
Are UTIs common?  20% of all women will get a UTI at some point in the lives.  20% of these women will suffer recurrent UTIs.
What causes UTIs?   In the majority of women, the bacteria that cause the UTIs enter the urinary tract from the genital tract, where their presence is normal.  Medications, spermicides, hormonal status, genetics, and acquired conditions all influence a woman’s susceptibility to UTIs.    
How are UTIs best diagnosed? The best way to diagnose a UTI is by an evaluation of the urine culture in relation to the urine analysis results and the patient’s clinical history.
Can you tell if a person has a UTI from a urine analysis (UA)? A UTI can be present in the face of negative UA and absent in the face of a positive UA.  Best practice guidelines call for evaluating the UA as part of the broader clinical picture.
Why are some urine culture results not accurate?  In women and some men, the urine specimen can easily get contaminated with bacteria that are naturally present in the genital tract and this results in a falsely positive urine culture. 
What is the best way to give a urine specimen to prevent contamination? A good way is to do a clean catch mid-stream collection.

Why is it important to make sure the urine culture results are accurate?
It is very important that patients are not exposed to side effects of medications, especially antibiotics, unless the benefits of treatment outweigh the risks. 
What are some of the risks of antibiotic therapy?
Antibiotics can cause diarrhea, yeast infections, rashes, and on rare occasion life-threatening allergic reactions.  Also, improper use of antibiotics leads to bacterial resistance and the emergence of very difficult to treat bacteria.
What are typical UTI symptoms?
For the majority of people, UTI symptoms are frequency, urgency, burning with urination and blood in the urine.  Not all people have all symptoms.  The very old and the very young may have no symptoms at all.
I feel fine, but my doctor told me I have a UTI.  What does this mean?  It means that the urine culture was positive but it does not mean you have a UTI.  This may reflect a contamination of the specimen.  More evaluation is needed.
What happens if my UTI goes un-treated?
While untreated UTIs can get worse and even cause kidney infections, it is very reasonable to confirm that the culture actually represents an infection prior to giving antibiotics.  In some cases, empiric treatment is warranted as well.