UTIs: Are You Among the High-Risk Groups?

Urinary tract infections (UTIs) are common but often overlooked conditions that can significantly impact our health. They act like "invisible killers," silently causing discomfort and complications if left untreated.

What Causes UTIs?

UTIs are caused by the growth and reproduction of bacteria, mycoplasma, chlamydia, and viruses in the urinary tract. This invasion triggers a series of inflammatory responses, akin to a "urinary tract war." Some patients may not exhibit obvious symptoms, making detection more challenging.

Why Are You Part of the "Susceptible Population"?

UTIs target specific "susceptible populations" rather than attacking indiscriminately. Infants, older adults, and adult women are the most commonly affected groups. Particularly, adult women face a high risk, with up to 60% experiencing at least one UTI in their lifetime due to their relatively shorter urethra, which allows bacteria to invade more easily. Additionally, poor lifestyle habits like holding urine or wearing tight clothing can increase the risk of UTIs.

If you experience the symptoms mentioned above, it is advisable to seek medical diagnosis and treatment promptly.

How to Screen for a UTI?

1. Physical Examination

- Initial Observation: The doctor will inquire about your medical history, including the nature, duration, and severity of symptoms and any previous history.

- Physical Examination: This includes palpation of the abdomen and lower back to check for tenderness, especially in the bladder and kidney areas. Women may need a simple gynecological exam, while men may undergo a prostate exam.

2. Urinalysis (Routine Urine Test)

- Visual Examination: Observing the color and clarity of urine to check for cloudiness or sediment.

- Dipstick Test: Using a dipstick to quickly test for abnormalities such as protein, glucose, blood, nitrites, and leukocyte esterase in the urine.

- Microscopic Examination: A sample is examined under a microscope to count white blood cells per high-power field (HPF). More than 5 WBCs/HPF usually indicate a UTI. Red blood cells, bacteria, and casts are also observed.

3. Urine Culture

- Collecting a midstream clean-catch urine sample, sometimes obtained via catheterization or suprapubic aspiration, for bacterial culture and sensitivity testing. A bacterial count of more than 10^5 CFU/ml (colony-forming units per milliliter) is generally considered evidence of infection, helping to identify the specific pathogen and its antibiotic sensitivity.

4. Rapid Screening Tests

- Nitrite Test: Certain bacteria can convert nitrate into nitrite, and a positive test suggests a possible infection.

- Leukocyte Esterase Test: This test detects leukocyte esterase, and a positive result indicates the likelihood of a UTI.

5. Imaging Tests

- In some cases, imaging tests like ultrasound, abdominal X-rays, CT scans, or intravenous pyelography may be needed to evaluate for structural abnormalities, such as stones, tumors, or congenital anomalies, which could lead to recurrent infections.

6. Blood Tests

- Although not a direct screening method for UTIs, blood tests can help assess the severity of infection in complicated or severe cases by checking for elevated white blood cell counts.

How to Treat a UTI?

1. Drink Plenty of Water

- Drinking plenty of water (about 2000 milliliters per day) can increase urine output, which helps flush bacteria, alleviating symptoms and speeding up recovery.

2. Get Adequate Rest

- Ensure sufficient rest, as fatigue can weaken the immune system, making it harder to fight off infections.

3. Medication

- Following the doctor's prescription, the appropriate use of antibiotics is crucial for treatment. Common antibiotics include quinolones (levofloxacin and ofloxacin), cephalosporins, and sulfonamides. The choice of antibiotics should be based on the results of urine culture and sensitivity tests to ensure strong targeting and effectiveness. Additionally, patients can consider traditional Chinese medicine like Diuretic and Anti-inflammatory Pill, especially for recurrent UTIs.

4. Lifestyle Adjustments

- Control Blood Sugar: For diabetic patients, controlling blood sugar levels can reduce the chances of bacterial growth.

- Improve Diet: Avoid spicy and irritating foods, and reduce caffeine and alcohol intake, as these can irritate the urinary tract.

- Regular Urination: Avoid holding urine and urinate regularly to reduce the time bacteria stay in the bladder.

- Personal Hygiene: Maintain cleanliness of the genital area. Women should wipe from front to back after using the toilet to prevent the spread of bacteria from the anus to the urethra.

5. Handling Special Cases

- For men, especially those with prostate issues, targeted treatment for prostatitis and other underlying problems is necessary. Chronic or complicated UTIs may require longer treatment periods or different combinations of medications.

6. Follow Medical Advice

- It is crucial to follow the doctor's guidance for any treatment measures, adhere strictly to the medication regimen, and complete the entire course of treatment. To prevent the development of antibiotic-resistant bacteria, avoid stopping medication or switching drugs without consulting a doctor.