Urinary tract infections or UTIs are primarily caused by micro-organisms such as bacteria or fungi entering the urinary tract through the urethra. Most common type of bacterium causing urine infections is the Escherichia coli or E.Coli bacterium. In majority of the cases, the e coli infection occurs due to use of catheters (medical devices used for draining urine from the bladder). Additionally, people (mostly women) with weakened immune systems as well as those suffering from diabetes, allergies, or abnormalities of urine flow, urine incontinence, or prolonged antibiotic use, pregnancy and low estrogen levels can also be at a risk for e coli infection in the UTI.
UTIs account for more than 7 million doctor office visits and over 1 million hospital admissions in the United States alone.
What causes E coli infections in the urine?
The bacteria causing the UTIs are similar to those naturally occurring in our bodies, in the colon and other parts of the excretory system. The e coli bacteria have the ability to adhere to the mucous membrane found in the lower urinary tract. This region has molecules called mannose, which are nothing but a form of sugar. The e coli infection is triggered when the bacterial strains adhere to the mannose preventing it from being flushed out of the system. Once the bacterium has bound to the sugar cells, they tend to invade the cells leading to bacterial colonization in the urinary tract. Once such an invasion has occurred, it is very difficult for the body’s immune system (or even antibiotic agents) to get rid of the e coli infection.
Why are bacterial UTIs more common in females?
E coli infection is more common in women than in men because:
- Women have shorter urethra than those in men. This makes it easier for the E. coli bacteria to reach the bladders.
- The opening of the urethra is also closer to the anus and external genitalia as a result of which bacterial cross contamination is more predominant in women than men.
- Frequent sexual intercourse (more than twice a week with different partners) also tends to increase the risk of bacterial UTIs in women. Additionally, women using diaphragms for birth control are more prone to e coli infection.
- Family history of UTIs, especially if one’s mother or sister has suffered from frequent urine infections, can also increase this risk in a female.
- Hormonal changes during pregnancy often cause a change in the position of urinary tract making it easier for the bacterium to travel there, thereby increasing a woman’s risk of getting UTIs.
- In post menopausal women, hormonal changes also cause a change in the vaginal walls due to a drop in the estrogen levels. Thinner vaginal walls become more susceptible to e coli infection.
In men, diabetes, prolonged use of antibiotics or catheters as well as those with anatomical urine flow abnormalities can all increase the risk of bacterial e coli urine infections.
Signs and Symptoms of E. Coli Infection in the Urinary Tract
There are different signs and symptoms that are indicative of e coli infection.
In the lower urinary tract, cystitis is common which has the following signs:
- Painful or burning sensation when urinating
- Higher frequency of urination but producing only 2 or 3 drops each time
- Producing cloudy, pink or reddish urine
- Urine has a strong odor
- In women, there is pain in the pelvic region
The e coli infection can also travel upwards to the kidneys causing a serious condition called Pyelonephritis. This is characterized by the following symptoms:
- High fever
- Abdominal pain
- Frequent painful urination
Treating bacterial UTIs
The majority of bacterial UTIs can be treated with antibiotics. However, it is essential to choose the right one, based on the bacterial resistance patterns. There are several E. coli strains that are resistant to many antibiotics. Hence, doctors need to prescribe the right dosage and treatment based on regional resistant factors as well as individual cases. In most cases of e coli infection, people tend to feel better within a couple of days of starting the treatment. However, the dose must not be discontinued when this happens. The full course of antibiotics prescribed for the e coli infection must be completed to prevent recurrence.