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Frequently Asked Questions

What is a urinary tract infection (UTI)?

General details and information on Urinary Tract Infections.

What causes UTIs?

Some of the most common causes and ways to avoid urinary tract infections.

What are the signs and symptoms of a UTI and how are they diagnosed?

Some of the common ways to identify a urinary tract infection.

Are UTIs serious?

Get the facts on the severity and long-term effects of urinary tract infection.

How common are UTIs in adults?

Learn about the frequency and statistics of urinary tract infection.

Recurrent Infections

Get inside information on recurring urinary tract infections and how to deal with them

How are UTIs treated?

Learn about the treatment options and remedies for urinary tract infection.

Points to Remember

A digest of the most important facts and details about urinary tract infection.

What is a urinary tract infection (UTI)?

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A UTI is an infection in the urinary tract. Infections are caused by microbes—organisms too small to be seen without a microscope—including fungi, viruses, and bacteria. Bacteria are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are rapidly removed by the body before they cause symptoms. However, sometimes bacteria overcome the body’s natural defenses and cause infection. An infection in the urethra is called urethritis. A bladder infection is called cystitis. Bacteria may travel up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis. [Top]

What causes UTIs?

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Most UTIs are caused by bacteria that live in the bowel. The bacterium Escherichia coli (E. coli) causes the vast majority of UTIs. Microbes called Chlamydia and Mycoplasma can infect the urethra and reproductive system but not the bladder.Chlamydia and Mycoplasma infections may be sexually transmitted and require treatment of sexual partners.

The urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act like one-way valves to prevent urine from backing up toward the kidneys, and urination washes microbes out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. But despite these safeguards, infections still occur. Certain bacteria have a strong ability to attach themselves to the lining of the urinary tract. [Top]

What are the signs and symptoms of a UTI and how are they diagnosed?

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Symptoms of a UTI vary by age, gender, and whether a catheter is present. Among young women, UTI symptoms typically include a frequent and intense urge to urinate and a painful, burning feeling in the bladder or urethra during urination. The amount of urine may be very small. Older women and men are more likely to be tired, shaky, and weak and have muscle aches and abdominal pain. Urine may look cloudy, dark, or bloody or have a foul smell. In a person with a catheter, the only symptom may be fever that cannot be attributed to any other cause. Normally, UTIs do not cause fever if they are in the bladder. A fever may mean the infection has reached the kidneys or has penetrated the prostate. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, and vomiting.

To find out whether a person has a UTI, the health care provider will ask about urinary symptoms and then test a sample of urine for the presence of bacteria and white blood cells, which are produced by the body to fight infection. Because bacteria can be found in the urine of healthy individuals, a UTI is diagnosed based both on symptoms and a laboratory test. The person will be asked to give a “clean catch” urine sample by washing the genital area and collecting a “midstream” sample of urine in a sterile container. This method of collecting urine helps prevent bacteria around the genital area from getting into the sample and confusing the test results. Usually, the sample is sent to a laboratory, although some health care providers’ offices are equipped to do the testing. For people with recurring infections and patients in the hospital, the urine may be cultured. The culture is performed by placing part of the urine sample in a tube or dish with a substance that encourages any bacteria present to grow. Once the bacteria have multiplied, which usually takes 1 to 3 days, they can be identified. The health care provider may also order a sensitivity test, which tests the bacteria for sensitivity to different antibiotics to see which medication is best for treating the infection. [Top]

Are UTIs serious?

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Most UTIs are not serious, but some infections can lead to serious problems, such as kidney infections. Chronic kidney infections—infections that recur or last a long time—can cause permanent damage, including kidney scars, poor kidney function, high blood pressure, and other problems. Some acute kidney infections—infections that develop suddenly—can be life threatening, especially if the bacteria enter the bloodstream, a condition called septicemia. [Top]

How common are UTIs in adults?

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Urinary tract infections are the second most common type of infection in the body, accounting for about 8.1 million visits to health care providers each year1. Women are especially prone to UTIs for anatomical reasons. One factor is that a woman’s urethra is shorter, allowing bacteria quicker access to the bladder. Also, a woman’s urethral opening is near sources of bacteria from the anus and vagina. For women, the lifetime risk of having a UTI is greater than 50 percent2. UTIs in men are not as common as in women but can be serious when they occur. [Top]

Recurrent Infections

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Many women suffer from frequent UTIs. About 20 percent of young women with a first UTI will have a recurrent infection4. With each UTI, the risk that a woman will continue having recurrent UTIs increases5. Some women have three or more UTIs a year. However, very few women will have frequent infections throughout their lives. More typically, a woman will have a period of 1 or 2 years with frequent infections, after which recurring infections cease.

Men are less likely than women to have a first UTI. But once a man has a UTI, he is likely to have another because bacteria can hide deep inside prostate tissue. Anyone who has diabetes or a problem that makes it hard to urinate may have repeat infections.

Research funded by the National Institutes of Health (NIH) suggests that one factor behind recurrent UTIs may be the ability of bacteria to attach to cells lining the urinary tract. One NIH-funded study found that bacteria formed a protective film on the inner lining of the bladder in mice6. If a similar process can be demonstrated in humans, the discovery may lead to new treatments to prevent recurrent UTIs. Another line of research has indicated that women who are “nonsecretors” of certain blood group antigens may be more prone to recurrent UTIs because the cells lining the vagina and urethra may allow bacteria to attach more easily. A nonsecretor is a person with an A, B, or AB blood type who does not secrete the normal antigens for that blood type in bodily fluids, such as fluids that line the bladder wall7. [Top]

How are UTIs treated?

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Most UTIs are caused by bacteria, which are treated with bacteria-fighting medications called antibiotics or antimicrobials. The choice of medication and length of treatment depend on the patient’s history and the type of bacteria causing the infection. Some antibiotics may be ruled out if a person has allergies to them. The sensitivity test takes 48 hours to complete and is especially useful in helping the health care provider select the antibiotic most likely to be effective in treating an infection. Longer treatment may be needed if the first antibiotic given is not effective.

When a UTI occurs in a healthy person with a normal, unobstructed urinary tract, the term uncomplicated is used to describe the infection. Most young women who have UTIs have uncomplicated UTIs, which can be cured with 2 or 3 days of treatment. Single-dose treatment is less effective. Longer treatment causes more side effects and is not more effective. A follow-up urinalysis helps to confirm the urinary tract is infection-free. Taking the full course of treatment is important because symptoms may disappear before the infection is fully cleared.

Complicated UTIs occur when a person—for example, a pregnant woman or a transplant patient—is weakened by another condition. A UTI is also complicated when the person has a structural or functional abnormality of the urinary tract, such as an obstructive kidney stone or prostate enlargement that squeezes the urethra. Health care providers should assume that men and boys have a complicated UTI until proven otherwise.

Severely ill patients with kidney infections may be hospitalized until they can take fluids and needed medications on their own. Kidney infections may require several weeks of antibiotic treatment. Kidney infections in adults rarely lead to kidney damage or kidney failure unless they go untreated or are associated with urinary tract obstruction.

Bladder infections are generally self-limiting, but antibiotic treatment significantly shortens the duration of symptoms. People usually feel better within a day or two of treatment. Symptoms of kidney and prostate infections last longer. Drinking lots of fluids and urinating frequently will speed healing. If needed, various medications are available to relieve the pain of a UTI. A heating pad on the back or abdomen may also help. [Top]

Points to Remember

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  • Most urinary tract infections (UTIs) arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the bowel.
  • Symptoms of a UTI in adults may include the following:
    • a frequent and intense urge to urinate
    • a painful, burning feeling in the bladder or urethra during urination
    • feeling tired, shaky, and weak
    • muscle aches
    • abdominal pain
    • only small amounts of urine passed, despite a strong urge to urinate
    • cloudy, dark, or bloody urine or urine that has a foul smell
    • pain in the back or side below the ribs
    • nausea and vomiting
  • Fever may indicate a kidney or prostate infection.
  • Because bacteria can be found in the urine of healthy individuals, a UTI is diagnosed based both on symptoms and a laboratory test.
  • UTIs are treated with bacteria-fighting medications called antibiotics or antimicrobials.

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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.The NIDDK would like to thank:

Betsy Foxman, Ph.D., University of Michigan School of Public Health; Anthony Schaeffer, M.D., Northwestern University Medical School

This information is not copyrighted. The NIDDK encourages people to share this content freely.

1Schappert SM, Rechtsteiner EA. Ambulatory medical care utilization estimates for 2006. National health statistics reports; no 8. Hyattsville, MD: National Center for Health Statistics; 2008.

2Griebling TL. Urinary tract infection in women. In: Litwin MS, Saigal CS, eds. Urologic Diseases in America. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, D.C.: GPO; 2007. NIH publication 07–5512:587–619.

3Hooton TM, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America. Clinical Infectious Diseases. 2010;50(5):625–663.

4Tolkoff-Rubin NE, Cotran RS, Rubin RH. Urinary tract infection, pyelonephritis, and reflux nephropathy. In: Brenner BM, ed. Brenner & Rector’s The Kidney. 8th ed. Vol. 2. Philadelphia: Saunders; 2008: 1203–1238.

5Schaeffer AJ. Infections of the urinary tract. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, eds. Campbell’s Urology. 8th ed. Vol. 1. Philadelphia: Saunders; 2002: 515–602.

6Anderson GG, Palermo JJ, Schilling JD, et al. Intracellular bacterial biofilm-like pods in urinary tract infections. Science. 2003;301:105–107.

7Stapleton AE, Nudelman E, Clausen H, Hakomori S, Stamm WE. Binding of uropathogenic Escherichia coli R45 to glycolipids extracted from vaginal epithelial cells is dependent on histo-blood group secretor status. Journal of Clinical Investigation. 1992;90;965–972.

8Sharma JB, Aggarwal S, Singhal S, Kumar S, Roy KK. Prevalence of urinary incontinence and other urological problems during pregnancy: a questionnaire based study. Archives of Gynecology and Obstetrics. 2009;279(6):845–851.

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