Wissenswertes

Urinary Tract Infections-A silent risk for health

Urinary Tract Infections (UTI) – A silent risk for health

According to several studies, the urinary tract infection is one of the most common bacterial infection around the world (1,2). Women present 9 times more risk of developing UTI than men (2). This condition is due to the fact that women have a shorter urethra than men, so bacteria can easily pass to the bladder. (3). Normally, healthy persons have bacteria-free urine in the bladder. Sometimes it can happen though, that bacteria come in the urinary tract and they are easily eliminated by the body, but in other cases, bacterias are stronger than the body's defenses and then, an infection appears. In general, UTI are asymptomatic (without symptoms), which represent a serious silent risk for health.

Besides, UTI are the most frequent complications during pregnancy and usually they are also asymptomatic. So, if they are not treated on time they can have important consequences for pregnant women and the baby's development such as a higher risk of pyelonephritis, intrauterine growth restriction, preeclampsia, preterm deliveries and cesarean delivery. Further, the infection can harm the kidneys, urethra, ureters and bladder in a progressive or irreversible way. Moreover, UTI are characterized by their high risk of recurrence during pregnancy or afterwards.

Good news are that UTI can be diagnosed in a simple test, which shows the amount of bacteria in the urine: The urine sample should contain a certain number of bacterias, usually stablished in ≥ 105 colony forming units pro mL of urine (UFC/ mL) (3-7). Some symptoms of UTI (symptomatic UTI) include dysuria (pain or ardor), increase in urinary frequency, sensation of not having urinated completely, or urgency (inability to hold the urine) (3,5,7)

Classification of urinary infections

It is important to mention that there are different kinds of urinary infections: “bacteriuria“ is the name given when bacteria appear in the urine test. The infection can be asymptomatic or symptomatic. If the infection is in the bladder, it is called cystitis; if it is in in the urethra it is denominated urethritis and if it is in the kidneys it is called pyelonephritis.

Urinary infections can also be classified as:

- uncomplicated urinary infections: These are the uncomplicated cystitis and pyelonephritis in young women without other health problems.

- complicated urinary infections: Urinary infections during pregnancy are considered as complicated.

- frequent urinary infections: these can appear due to the same causative agent or due to a different causative agent (re-infection)

- chronic urinary infections: In these kind of infections the same microorganism re-appears after treatment during months or years.

Cranberry – Help against urinary tract ınfections

Disregarding the type of UTI, it is very important to be able to recognize the subtle symptoms of the infection. In the case of asymptomatic bacteriuria, the good new is that there are still some symptoms that can be carefully watched such as the urine's color, odor, consistency; sensation before, during and after urinating; and body temperature. In order to prevent UTI there are some efficient natural alternatives such as the cranberry juice or the fruit itself. Several studies have concluded that Cranberries can help pregnant women to avoid UTI . Cranberries have been utilized for centuries for the prevention of urinary tract infections. It has been demonstrated that some of its components inhibit the bacteria from sticking to the epithelial cell lining of the urethra, and thus preventing urinary tract infections(3,7).

    References:

    1. Wagenlehner FM, Vahlensieck W, Bauer HW, Weidner W, Naber KG, Piechota HJ. Primary and secondary prevention of urinary tract infections. Urologe A. 2011 Oct; 50(10):1248, 1250-2, 1254-6.

    2. Ruz EN, González CC, Jaen Sde L, Escoto PG, Urquiza EK, Rosenfield LO, Ortiz CS, Castellanos PV. Cranberry juice and its role in urinary infections. Ginecol Obstet Mex. 2009 Nov;77(11):512-7.

    3. Jepson RG, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD001321.

    4. Hamdan HZ, Ziad AH, Ali SK, Adam I. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital. Ann Clin Microbiol Antimicrob. 2011 Jan 18;10:2.

    5. Celen S, Oruç AS, Karayalçin R, Saygan S, Unlü S, Polat B, Danişman N. Asymptomatic bacteriuria and antibacterial susceptibility patterns in an obstetric population. ISRN Obstet Gynecol. 2011;2011:721872. Epub 2011 Jan 24.

    6. Kehinde AO, Adedapo KS, Aimaikhu CO, Odukogbe AT, Olayemi O, Salako B. Significant bacteriuria among asymptomatic antenatal clinic attendees in Ibadan, Nigeria. Trop Med Health. 2011 Sep;39(3):73-6. Epub 2011 Sep 30.

    7. Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol. 2008 Oct;180(4):1367-72. Epub 2008 Aug 15.