Higher Female Risk For Urinary Tract Infection

Urinary Tract Infections (UTI) and Higher Female Risk

Females are especially prone to urinary tract infections. And the reasons for this are two fold:

If you remember our article on enteric bacteria? The article describes how numerous enteric bacteria are...but those bacteria are too close to the reproductive organs and the urethral opening, which is just above the sex organs. Also the urethra itself is shorter than it is in a male.

The distance from the urethral opening to the interior of the bladder is about one inch in the female. It is much longer in the male. So the key to prevention of urinary tract infection, (UTI) - in females- is good peri anal hygiene. That involves washing the anal area with soap and water, and good “wiping” habits. Wiping after stool should be directionally “away” from that urethral opening, wiping after urination should not be from bottom up. It should bet from top to bottom. (Avoiding dragging the tissue upward to wipe again.) Bacteria are invisible, wiping upward drags bacteria from the peri anal area to the perineum and the urethrial opening. We are talking about a place where 1/2 billion E. coli are, the most common cause, as it is the most abundant in the stoo), or it may be strep facalis organsims placed there. If wiping habits are wrong the bacteria between the anus and the urethra can enter the bladder. You might as well say "come on in."

They can't be seen, but they are there. And, they are always looking for new places to raise their off spring and build their civilizations.

The bacteria may see your bladder as a nice neighborhood, but it isn't. They are instantly attacked as soon as they enter that sterile environment by an instant climate change. The core body temp goes up, and they are attacked by white cells. So they fight and run (toward your kidneys) reproducing like mad along the way. A kind war is on at that point. and the host feels ill. That'd be you.

Urinary tract infections are almost invariably caused by enteric bacteria, E. coli, Proteus mirabilis, Klebsiella or other of the enteric normal flora.

While these bugs are ok in the intestine, they are not ok in the urine. While they are helpful in the intestine, they are a not well behaved in the bladder. Urine is sterile and should stay that way. The tract leading directionally out of the bladder to the two ureters, also leads to the kidneys, each kidney is supposed to be sterile, but they are at risk when a UTI occurs.

This is the tract urinary tract infections follow when they are not treated: Bladder- Ureters - Kidneys - Blood stream...When urinary tract infections travel that far it is because the infection was not treated when it was localized in the bladder. "Sepsis" or blood infection leads to septic shock and death. And also, before the bacteria get to the blood, they are causing kidney damage; the kidneys start leaking protein into the urine.The evidence is in simple lab tests.

In the lab, when a urine specimen arrives..the technician can see infection right away. The urine is usually cloudy, smelly. The technician dips a chemistry strip into the urine. It is capable of testing for the presence of protein, white cells, red cells, glucose, bilirubin. ketones, uric acid, and other things that should not be there - bacteria.

In urinary tract infection, the white cell section of the strip will change color, red cells may be present, bacteria will react with the strip, but If protein is present, that suggests kidney involvement. I have written an article present at the hub pages, it depicts voluminous amounts of information that can be determined from microscopic examination of the blood, after a wright's stain is observed under a microscope. The same is true for urine microscopy

. The technician pours the urine into a plastic test tub after determining that infection is probable, and after getting the specific gravity of the urine. He then spins the tube in a centrifuge, aspirates out some of the sediment and examines it under a microscope. In urine, if bladder infection is present, there will be many bacteria present, and zillions of their natural enemies visiblet: White cells. White cells gobble up bacteria. But if the war is being lost, there will also be be casts present, as the bacteria have damaged the basement membrane of the glomerulus of the kidney and protein is leaking out, In the observable forms most notably as Kidney casts with white cells.

The next task is to take some urine and streak it on agar plate rich with nutrients that bacteria love and stick it in an incubator. Then when he examines the plate in 24 to 48 hrs the tech will see a pure culture of the infective agent. The next step is the actual id of the bacteria, then it's sensitivity is done. "Sensitivity" is what identifies fhe antibiotic that will kill the bug. Another agar with antibiotic dots placed firm in the agar that has been streaked with urine. It is incubated. In time there will be a "zone of inhibition," or no growth, around the dot that has the best effect in terms of killing the bug. And if the patient is not allergic to that drug, that drug will be used. This analysis is called “Culture and Sensitivity.”

(Culture and sensivity test have evolved beyond this procedure. These days both can be done by sophisticated machines that determine characteristic growth patterns of different bacteria in translucent tubes. Light of a specific frequency is passes through the tube, and ID, sensitivity are determined by differential opacity, different bacteria reproduce at different rates and create very specific turbidity in a fixed time in a standard nutrient solution. The identification is based on absorbtion of light as it reaches a sensor on the other side.

Sensitivity is detemined by the reverse of this principle. The tubes are innoculated with different antibiotics, and under the same conditions the solution will become charactoristically more clear, less opaque, with the best antibiotic. This is because the bugs are being killed. Some drugs will not work, and the solution will stay cloudy with thriving bacteria. These bugs are labeled RESISTANT - SENSITIVE or INTERMEDIATE, based on the change or lack of change in the cloudiness of the solution. Some labs use this method now. It is 95 percent accurate, but very expensive because the method is automated. Many of the VA hospital have this system in their labs.)

How does the patient know if they have a UTI?

Fever, malaise, foul smelling urine, cloudy urine and urinary frequency - are the most common signs..the patient may spike high temps and get "chills," and if the kidney's get involved, they may get back pain below the rip cage, on one or both sides. (if both kidneys are infected.)

So, when these symptoms are present, it is best to go to a doctor right away before the bug can cause more harm. Women and elderly are most susceptible to UTI. Especially bed bound elderly who have lost control of bowel and bladder. The first sign in this crowd is often increased confusion. Prevention in the case of the elderly is good hygiene and peri care. In younger females, the hygiene habits mentioned are paramount. Sexual activity too could be the mechanical mechanisms dragging the bacteria too close to the perineum. So, good perineal care after sex is a good idea.

If UTI is present: increased fluids to flush bacteria is usually recommended, Also, drinking acidic drinks such as cranberry juice, is a help. Bacteria hate low PH.

(Note: Men with enlarged prostate or urethral obstruction, or who have indwelling catheters are more prone to infection to UTI. Also, if you have an elderly parent who seems confused suddenly, lethargic, or even hallucinating, the cause can be as simple as a urinary tract infection. For some reason the elderly are thrown wildly off kilter by UTI. )

PS: Earl Flemm has just chatised us for teaching women how to wipe. haha. It does take hutzpah for it's implications. But I wrote old Earl and said, look Earl, I've had to teach them everytime they were asked to get a clean catch urine for culture and sensitivity. But the theory behind that method is not usually taught. And, most people would not think there is a less risky way to wipe, but, there is...and so - the theory is explained here. No sexual politics here.Just science.

"No woman in their right mind is gonna listen to you prattle on about wiping." Well they should. I know what I'm talking about. I geuss Earl thinks we should just write songs and shut up. But, why?

Gary Stone BSN MLT (ASCP) Earl, that's why. I'll take my lumps. And I'm sure I'll get a few from the fem bots.

More info on UTI is here