Urinary Tract Infections

A urinary tract infection (UTI) is a serious and common medical issue. A UTI is an infection either in the lower urinary tract, a simple cystitis (bladder infection) or in the upper urinary tract pyelonephritis (a kidney infection). Symptoms include painful or frequent urination, accompanied by fever. Several different viruses or bacteria can cause this ailment. Whatever the causes, those treating patients with UTI have to take many things into consideration, one being the age and gender of the patient that they are treating. UTI affects gerontologic patients differently than it affects children.

Medical experts believe that elderly patients who acquire UTI are less likely to be cured by antimicrobial therapy than younger patients. Research, such as the Matsumoto and Kumazawa study, has shown that because there were possibly other “underlying diseases and diseases specifically of the urinary tract, (1999, p.271)” the treatment for this condition is less likely to be successful for elderly patients. Many times a diagnosis can be difficult for these patients because many of these symptoms are already commonplace in these patients’ daily lives, such as incontinence or fatigue. Therefore, many of these symptoms go ignored. Some of these same health concerns also make the risk of these elderly patients higher for developing UTI.

In addition to elderly patients, young girls under the age of 5 also have a higher risk of developing a UTI, due to their biological makeup. Women in general, because their urethras and anal areas are closer, are at a higher risk of developing UTI. For girls under 5 who are not physically fully developed, or whose immune systems have not fully strengthened, the risk is greater. According to Dairiki-Shortliife & McCue, “UTI is far more prevalent among females than males. Approximately 2.7% of boys experience UTI during the first year of life, which decreases to 0.03% to 1.2% during the school years. In contrast, the rate of UTI increases from 0.7 during the first 12 months to 1% to 3% during school years in girls” (2002, p. 565). The best way to prevent an infection from occurring is to practice good hygiene and toilet habits and to avoid certain bubble baths or soaps that may irritate the young girls’ sensitive urethra.

Parents need to be aware that acute glomerulonephritis can also cause UTI in children. During prolonged acute glomerulonephritis, the kidney filters responsible for the removal of waste and toxic products from the blood, which are excreted via urine, are damaged. Without a thorough filtration of waste, a build-up of toxins could lead to a UTI. This can ruin the kidneys if undiagnosed, which could lead to the need for a kidney transplant in young children. Many times if parents monitor the symptoms, or at least practice good hygiene, the bacteria and viruses that cause acute glomerulonephritis and UTI can be minimized.

Patients may come into a clinic with several disorders that have damaged their kidneys, referred to as Nephrotic syndrome. Healthcare providers can run blood tests or perform a kidney biopsy to diagnose this condition. Once diagnosed the patient can be treated with Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) or they can be put on a low sodium diet to avoid the high blood pressure that is related to this condition.

References

Dairiki-Shortliife, L.M., and McCue, J. D. (2002). Urinary tract infection at the age extremes: Pediatrics and geriatrics. University of Stanford Press. Retrieved from http://courses.washington.edu/pharm550/Week7/readingshortliffe.pdf.

Matsumoto, T., and Kumazawa, J. (1999). Urinary tract infection in geriatric patients. International Journal of Antimicrobial Agents. May; 11(3-4), 269-73. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10394982.