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Friday, 20 December 2013

Women health - Urinary Tract Infection - The Causes and Risk Factors

Urinary Tract Infection is defined as a condition of is a bacterial infection of any part of the urinary tract. Women are at 10 times higher risk of develop the disease than men, according to the statistic and at least 50% of women will develop at least one urinary tract infection in their life time.

Symptoms
1. Pain and burning sensation in urination
2. Abnormal vaginal discharge
3. Abnormal pain
4. Blood in the urine
5. Strong smelling urine
6. Painful sexual intercourse
7. Nausea, vomiting
8. Frequent urge to urinate
9. Etc.

Causes and risk factors
1. Multiple sex partner
Women who are sexual active with multiple partners are at higher risk of urinary tract infection as a result of sexual transmitting disease and bacteria invasion, according to the study of 468 women using the University of Michigan Health Service because of urinary symptoms, completed questionnaires regarding medical history, stress, clothing, diet, sexual activity, and birth control method during the previous 4 weeks. 1484 potential Health Service controls without urinary symptoms were selected as well as 115 student-population -based controls, conducted by University of Michigan School of Public Health, posted in PubMed, researchers found that UTIs significantly increased with the frequency of sexual intercourse.

2. Diabetes and aging
According to the study of "Urinary tract infections" by Litza JA, Brill JR., posted in PubMed, researchers indicated that Urinary tract infection (UTI) is the most common urologic disorder and one of the most common conditions for which physicians are consulted. Patients at increased risk for UTI include women; diabetics; the immunocompromised; and those with anatomic abnormalities, impaired mobility, incontinence, advanced age, and instrumentation

3. Pregnancy
It is said the women who are pregnant are at the increased risk of urinary tract infection in the between of 6 to 26 weeks, but according to the study of "Managing urinary tract infections" by
Saadeh SA, Mattoo TK., posted in PubMed, researchers wrote that patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure.
4. Bacterial infections
Bacteria is the main cause of all kinds of infection, including Urinary tract infection. In a study of "Urinary tract infections in women.Valiquette L, posted in PubMed, researcher indicated that
The predominant pathogen in both complicated and uncomplicated UTI remains pathogenic Escherichia coli, although Klebsiella sp. and Proteus appear with increased frequency in complicated UTI. Most often, bacteria cause UTIs by ascending means through the urethra into the bladder. Bacteria must possess virulence factors to cause UTI.

5. Contraceptive method
Believe or nor using contraceptive methods such as lubricated condom, a spermicidal cream or gel with an unlubricated condom increase the risk of urinary track infection by two-eightfolds in women. In a study of in a case-control study of sexually active college women ages 18-39 years. Cases (N = 144) were women with first urinary tract infection that was confirmed by culture recruited at the student health service, conducted by School of Public Health, University of Michigan, posted in PubMed, researchers found that using unlubricated condoms compared with using no birth control method strongly increased the risk of first urinary tract infection (odds ratio = 29.1; 95% confidence interval = 3.1-1,335). Using a lubricated condom (with or without spermicide in the lubricant) or a spermicidal cream or gel with an unlubricated condom was associated with two- to eightfold risk of first urinary tract infection. Unlubricated condom use was strongly associated with risk of first urinary tract infection, but this effect was largely neutralized by using a spermicidal cream or gel with the unlubricated condom or by using a lubricated condom.

6. Oral Contraceptions
Oral contraceptive method can cause hormone and glucose fluctuation that can lead urinary tract infection in some women. According to the study of In a cohort study, 200 women who chose DMPA for contraception were compared with 200 women who used the withdrawal method for urinary infection and urological symptoms after 3 months of consumption, conducted by Tarbiat Modarres University, posted in PubMed, researchers found that The rate of urinary infection and urological symptoms in the study group were higher than in the control group (p = 0.018, p < 0.0001, respectively). The most common microorganism that caused urinary infection was Escherichia coli. Among the 10 cases who suffered UTI in the case group, there were six women who had UTI in the previous pregnancy as well and concluded that We do not recommended administering depot-medroxyprogesterone acetate for contraception in women with a history of urinary tract infection in a previous pregnancy.

7. Tumors
Tumors and abnormal cell mass can cause UTs obstruction such as bladder and kidneys that can lead to urinary tract infection, in a study of "Occurrence of urinary tract infection in children with significant upper urinary tract obstruction" by Roth CC, Hubanks JM, Bright BC, Heinlen JE, Donovan BO, Kropp BP, Frimberger D., posted in PubMed, researchers found that Our results have demonstrated a low occurrence of UTI in antenatally diagnosed patients not maintained on antibiotics. We have concluded that antibiotic prophylaxis is unlikely to benefit most children with grade 3 or 4 hydronephrosis secondary to upper tract obstruction.

8. Medical history
Women who have a previous urinary tract infection are at higher risk to have it gain. According to the study of " Risk factors for urinary tract infection" by Remis RS, Gurwith MJ, Gurwith D, Hargrett-Bean NT, Layde PM., posted in PubMed, researchers wrote that the history of previous urinary tract infection was significantly greater in cases than in either of the control groups.

9. Weakened immune system
Immune system protect our body in fighting against the foreign invasion, including bacteria and virus. according to the study of " The innate immune response to uropathogenic Escherichia coli involves IL-17A in a murine model of urinary tract infection" by Sivick KE, Schaller MA, Smith SN, Mobley HL , posted by PubMed, researchers concluded that transcript expression of IL-17A in the bladders of infected mice correlated with a role in the innate immune response to UTI, and gammadelta cells seem to be a key source of IL-17A production. Although IL-17A seems to be dispensable for the generation of a protective response to uropathogenic E. coli, its importance in innate immunity is demonstrated by a defect in acute clearance of uropathogenic E. coli in IL-17A(-/-) mice. This clearance defect is likely a result of deficient cytokine and chemokine transcripts and impaired macrophage and neutrophil influx during infection. These results show that IL-17A is a key mediator for the innate immune response to UTIs.

10. Antibiotics
Antibiotics are used to treat bacteria infection can also suppress the immune system and cause mutation of the bacteria that can increase the risk of urinary tract and other infections. According to the study of 349 transplant recipients, 77% received induction therapy with low-dose rabbit antithymocyte globulin (rATG) and the others were treated with basiliximab. All patients received triple immunosuppression with tacrolimus, mycophenolic acid, and prednisone, conducted by Buffalo General Hospital, Buffalo, posted in PubMed, researchers found that Seven patients (2%) developed wound infections. Wound infections were more common in obese and older patients. All wound infections were superficial and responded well to wound drainage and outpatient antibiotic therapy. Six patients (1.7%) experienced a urinary tract infection (UTI) within the first postoperative month. UTIs were more common in the patient with ureteral stent compared to nonstented patients (11.4% vs 0.3%, P<.001). No patient or graft was lost due to perioperative bacterial infections (PBI).

11. Renal insufficiency
Reduced kidney function can increase the riak of urinary tract infection. According to the study of "The interaction of urinary tract infection and renal insufficiency" by Fünfstück R, Ott U, Naber KG., posted in PubMed, reasearchers found that Defence factors (Tamm-Horsfall protein, defensin, phagocytic activity of granulocytes) and underlying anatomical lesions as well as pre-existing renal disease determine the severity of UTI and the prognosis of renal insufficiency.

12. Etc.

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