Is there a risk of getting a serious urinary tract infection (UTI)?

An overview of health problems that can make UTIs more frequent or harder to treat

How common are UTIs and how bad can they get?

UTI is one of the most frequently seen microbial infections in the world and in a typical year occurs in about 2% of the global population. Some 90% of patients are women. In fact, 50% of all women in the U.S. will have at least one UTI by the time they are 35, and ~20% of women aged 18-24 even experience it annually. The risks of getting UTI is less severe for middle-aged women but the risks rise again in and after menopause. Aside from age, existing diabetes is a risk factor.

Usually, a UTI is an uncomfortable but harmless bladder infection that’s easy to treat and the most important thing to watch out for is that you’re always close to a bathroom. At the worst, you may need to take antibiotic drugs for a few days.

Much more rarely though, UTI can become a chronic disease that is increasingly difficult to treat. These are called complicated UTI. If untreated or no progress is made in treating a complicated UTI, it can eventually infect the kidneys and thus turn into a life-threatening condition. The symptoms of a kidney infection can be a fever above 100 degrees, back pain, queasiness and vomiting, and chills across the entire body.

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There about 1.3 million cases of complicated UTI in the U.S. every year, and within these 1.3 million the mortality is slightly less than 2%. So, while you should take UTI, whether simple or complicated, very seriously and get it treated immediately, in the U.S. it’s not a disease with a high mortality risk.

What preexisting health issues can increase the risks of getting complicated UTI?

There are several health problems that can raise the frequency of UTI or make it more difficult to successfully treat it. Here we take a look at the most prevalent risk factors.

  • Diabetes: If you suffer from diabetes mellitus and don’t carefully control your blood sugar levels, there’s increased risk of having UTI occur more often and in greater severity. Unfortunately, every UTI also carries a greater risk of triggering a kidney infection. That said, if you keep tight control on your blood glucose levels, your chances of getting UTI are about the same as for people who don’t have diabetes. It therefore is very important that you frequently monitor and manage your blood sugar together with your endocrinologist.
  • Weak immune system: If you have a medical condition that weakens your immune system (such as HIV, cancer, or sickle cell anemia) or if you are older than 60, your immune system most likely is weaker than in a younger healthy person. It’s normal for the immune system to weaken with growing age, and that’s why the frequency of UTI also increases with age 50. 
  • Pregnancy: UTI can be more common during pregnancy, since the expanding uterus sometimes weighs on the bladder and prevents the latter from draining out all urine. Any UTI occurring during pregnancy is by default considered a complicated UTI — even if the symptoms are mild — because if untreated and severe it can have serious consequences for mother and child, such as premature birth and low newborn weight. 
  • Kidney stones: Having kidney stones, regardless of which kind, raises the risks of getting a getting a more serious UTIs. This is because when a kidney stone loosens and starts passing out, the stone can get stuck in the urinary canal between kidney and bladder. It’s a very painful event, so you’ll definitely notice and you must immediately seek medical help. If the stone is stuck there for too long, it can be dangerous. Especially if you have UTI, because bacteria from the bladder can now more easily get to the kidneys.  
  • Previous urinary tract surgery: If you had a procedure done at the urinary tract (which means the entire system from the kidney to the bladder to the urine exit point), the risks of getting a complicated UTI is larger and UTI may also be more difficult to treat. Urinary tract procedures include bladder lifts, ureteral stents, kidney biopsy, and cystoscopy. 
  • Medication use: Drugs that weaken your immune system make it easier for bacteria to colonize your urinary tract and cause more serious UTI. Such medication includes steroids and drugs used to tackle autoimmune disorders, but also arthritis infusions and meds against inflammatory bowel disease. Chemotherapy drugs will also weaken your immune system. If you are taking any medication or supplements regularly, it’s generally a good idea to check with your doctor whether these drugs can increase the risk of getting a more serious UTI.

  
References

  1. Ayan Sabih, and Stephen W Leslie. “Complicated Urinary Tract Infections.” Nih.Gov, StatPearls Publishing, 5 Mar. 2019, www.ncbi.nlm.nih.gov/books/NBK436013/. Accessed 26 Jan. 2020.
  2. Flores-Mireles, Ana L., et al. “Urinary Tract Infections: Epidemiology, Mechanisms of Infection and Treatment Options.” Nature Reviews Microbiology, vol. 13, no. 5, 8 Apr. 2015, pp. 269–284, 10.1038/nrmicro3432. Accessed 26 Jan. 2020.
  3. Storme, Oscar, et al. “Risk Factors and Predisposing Conditions for Urinary Tract Infection.” Therapeutic Advances in Urology, vol. 11, Jan. 2019, p. 175628721881438, www.ncbi.nlm.nih.gov/pmc/articles/PMC6502981/, 10.1177/1756287218814382. Accessed 26 Jan. 2020.

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