Urinary tract infection (UTI) cab be defined as “the presence of pathogens in the urinary tract” (Rane & Dasgupta, 2013, p. 1). In fact, UTI is “an inflammation of the urinary epithelium” commonly conditioned by gut flora bacteria (Huether & McCance, 2017, p. 2263). The most frequent cause of UTI is Escherichia coli. Nevertheless, UTI can develop as a result of certain viruses, fungi or parasites. Moreover, UTI is among prevalent reasons for the prescription of antibiotics. The infection can affect the lower and upper urinary tract. In addition, it can be affected by different factors such as age, gender or lifestyles. Consequently, it is crucial to have a clear picture of UTIs and understand the factors that influence its development to provide a proper timely diagnosis.
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Pathophysiology of Urinary Tract Infections
UTI can develop in lower and upper urinary tracts. The infection can locate in the urethra, bladder, prostate (in male patients), ureter, and kidney (Huether & McCance, 2017). Although the causes of UTI are often similar, pathophysiology can differ depending on the location of infection.
Lower UTI includes cystitis and urethritis. It can be described as a benign state that provokes such characteristic symptoms as “dysuria, suprapubic pain, frequency of micturition, urgency, hesitancy, and incomplete voiding” (Rane & Dasgupta, 2013, p. 1). Cystitis is mainly caused by such infecting microorganisms as Escherichia coli and Staphylococcus saprophyticus. Other infection matters include Klebsiella, Proteus, Pseudomonas, parasites, viruses, fungi, or tubercular bacilli (Huether & McCance, 2017).
Upper UTI is represented by pyelonephritis. It is “an invasive infection of the renal parenchyma, classically presenting with the triad of fever, renal angle tenderness, and nausea and vomiting” (Rane & Dasgupta, 2013, p. 1). Pyelonephritis is frequently caused by Escherichia coli, Proteus, and Pseudomonas (Huether & McCance, 2017). In both lower and upper UTI the infection is commonly spread by uropathic microorganisms that ascend along the ureters. Still, bloodstream is another possible way for dissemination. The inflammatory process usually is of irregular and focal character. It mainly influences the pelvis, calyces, and medulla (Huether & McCance, 2017).
On the whole, infections of lower and upper urinary tracts have some similar causes such as Escherichia coli, Proteus, and Pseudomonas. However, infection is located in different parts of UT and the symptoms are different. Moreover, upper tract infections can cause urosepsis and other complications such as abscess formation, kidney damage, or renal failure (Flores-Mireles, Walker, Caparon, & Hultgren, 2015).
Gender and Behavior as Factors Influencing the Pathophysiology of UTI
Among the factors that have impact on UTI, gender and behavior are probably among the most significant. Thus, women are more exposed to UTI, sexually active, pregnant, or treated with antibiotics women in particular. Bacteria causing UTI are moving into the urinary tract from the bowel, vaginal cavity, and periurethral area (Foxman, 2017). Women have a shorted distance between vaginal cavity and anal and the urethral opening. Thus, bacteria reach the bladder quicker. Cystitis is frequent among women due to the shorter urethra which increases the probability of bacterial contamination. Lower UTI affects about half of women at some time in their life (Huether & McCance, 2017).
People’s behavior or lifestyles also have a significant influence on the development of UTI. Thus, poor hygiene stimulates pathological processes and increases the risk of bacterial contamination. Active sexual life is also a factor that increases the probability of developing a UTI because it assists the movement of bacteria into the urethra thus causing infection.
On the whole, UTI is among the most common diseases. It can develop in different locations and have diverse causes or be influenced by many factors. Although it is successfully treated with antibiotics, UTI has a high rate of recurrence.
Flores-Mireles, A., Walker, J., Caparon, M., & Hultgren, S. (2015). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, 13(5), 269-284. Web.
Foxman, B. (2017). Urinary tract infection syndromes. Occurrence, reoccurrence, bacteriology, risk factors, and disease burden. Infectious Disease Clinics of North America, 28(1), 1-13. Web.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Rane, A., & Dasgupta, R. (Eds.). (2013). Urinary tract infection. Clinical perspectives on urinary tract infection. London, UK: Springer.