Bacteria, Epidemiology, Infectious Diseases, Microbiology, Wellness

Urinary Tract Infections (UTI): Signs, Causes, Treatment, and Prevention

Author Chandana Balasubramanian , 25-Jul-2023

A urinary tract infection or UTI is a very common bacterial infection, impacting approximately 150 million individuals worldwide annually.


Each year, in the United States, UTIs contribute to over 10 million office visits, surpass 2 million emergency department visits, and result in 100,000 hospitalizations. As a result, estimated costs linked to these infections in the US range from $1 billion to $1.6 billion annually, including both direct and indirect expenses.


Around 40% of women are estimated to have experienced a UTI at some stage in their lives. Although sexually active young women bear a higher burden, other people are also susceptible to these infections. These include the elderly, individuals undergoing surgery on their urinary tracts, and those who get catheters inserted.



The existence of urinary tract infections has been known since ancient times, and the earliest recorded description can be traced back to the Ebers Papyrus from 1550 BC. The Egyptians also described it as a condition characterized by the emission of heat from the bladder.

The discovery of antibiotics started with penicillin in 1928, which revolutionized the treatment of infectious diseases like UTIs. As a result, antibiotics are now widely used in the treatment of UTIs.

However, the excessive use of antibiotics led to the rise of antibiotic resistance, posing a severe threat. For instance, ciprofloxacin, an antibiotic used for UTIs, now faces a resistance rate of 92.9%. As a result, urgent action is needed to address this antibiotic resistance issue and preserve these life-saving medications.



UTIs are widespread bacterial infections among women that typically occur in the age range of 16 to 35 years, with 10% of women experiencing an infection each year. Given that they are so common, about 40% to 60% of women experience at least one UTI in their lifetime.

UTIs are expected to recur, with nearly half of the women experiencing a second infection within a year. Because of this, they are more prevalent in females than males, occurring at least four times more frequently.

UTIs are one of the most common infections in women. These infections are uncommon in circumcised males – any male UTI is usually considered complicated.

More than 4 million patients in the European Union acquire healthcare-associated infections (HAIs) annually, and around 20% to 30% of these infections are considered preventable. Healthcare-associated urinary tract infections (HAUTIs) are the most common among all HAIs.

Studies show that the prevalence of HAUTIs varies, ranging from 12.9% in the US and 19.6% in Europe to as high as 24% in developing countries.

In Sub-Saharan Africa, the general prevalence of UTIs is 32.12%. Among the countries studied, South Africa had the highest prevalence at 67.6%, followed by Nigeria at 43.65% and Zambia at 38.25%. The prevalence in South Africa was based on a single study involving 712 women, where the diagnosis was confirmed through urine culture. In Senegal, the prevalence was reported as 5.1% based on a retrospective study involving 1922 hospitalized patients.


How is it spread?

Although our bodies have many in-built defense systems against infectious agents, these defenses can fail, like in the case of a UTI.

Factors that increase the risk of developing a UTI include:

  • Female anatomy because the urethra is close to the anus, and the urethral opening is near the urinary bladder, making it easier for bacteria to travel between the two
  • Sexual activity when friction during sex drives bacteria closer to the urethra
  • Certain types of birth control, like diaphragms because they have spermicidal agents that can kill healthy bacteria in the vagina
  • Menopause when estrogen levels are lower and can alter the bacterial composition of the vagina and bladder
  • Urinary tract abnormalities blocking urine flow or causing urine backflow
  • Suppressed immune system due to diabetes or other diseases, and
  • Catheter use since these devices pose the risk of introducing bacteria into the urethra and bladder.


Biology of the disease

UTIs are caused by bacteria, most commonly E.coli, that sneak in through the urethra and travel up to the bladder. The body’s defense mechanisms usually prevent these bacteria from causing infection, but sometimes they manage to overcome these defenses and multiply rapidly.

These microbes in the urinary system can result in:

  • Irritation and inflammation
  • Frequent urination
  • Burning or pain when urinating
  • Murky urine, and
  • Discomfort in the lower abdomen.

Unattended UTIs may spread to the kidneys, potentially leading to further difficulties such as kidney infections.


UTI Symptoms

UTIs often come with various symptoms that can vary in severity. Infected individuals may:

  • Feel a powerful need to urinate
  • Experience discomfort while urinating
  • Have urine that is hazy or has an unpleasant odor
  • Get lower abdominal pain or discomfort.


In severe cases, UTIs can cause:

  • Upper back and side pain
  • High fever
  • Shaking and chills
  • Nausea and vomiting.

Severe symptoms may suggest that the infection has reached the kidneys, a condition known as pyelonephritis that requires immediate medical attention. Due to the severity of this issue, healthcare professionals must recognize these signs early for prompt diagnosis and treatment.


UTI Diagnosis

As a first step, healthcare providers ask their patients about the signs and symptoms of UTIs and perform a physical check. Next, a urine sample helps diagnose and pinpoint the bacteria triggering the infection. The urine samples are then sent to the laboratory for a urine culture test.


UTI Treatment

UTIs are a pain in the bladder, but luckily they can be treated with antibiotics. The type of antibiotic and length of treatment depends on the patient’s history and urine test results.

The Mayo Clinic suggests a short course of antibiotics for superficial infections, while more complicated cases might require more prolonged treatment. Pain relief is also an essential aspect of UTI management. Over-the-counter pain medication can help alleviate discomfort during urination until the infection clears.

For some, long-term low-dosage antibiotics may be prescribed to prevent recurrent UTIs in postmenopausal women or those who frequently experience them.


UTI Prevention

The best defense against UTIs is prevention.

  • Maintain hygiene in the genital area
  • Drink lots of liquids
  • Urinate frequently to reduce the odds of contracting a UTI
  • Opt for showers over baths
  • Avoid excessive use of douching products, sprays, or powders in the genital area because it can change vaginal pH and the balance of healthy bacteria
  • Teach girls to wipe from front to back during potty training.


The Mayo Clinic recommends avoiding potentially irritating feminine products and switching up birth control methods if UTIs return.

Unfortunately, there is currently no vaccine to protect against UTIs. However, research indicates that one may soon be developed. In healthcare settings, preventing catheter-associated UTIs involves using catheters only when necessary and removing them as soon as possible to minimize exposure to bacteria.

FAQs about Urinary Tract Infections (UTI)

What are the symptoms of a UTI?

UTI symptoms include frequent urination with pain or burning sensation, lower abdominal discomfort, cloudy urine, fever, and flank pain in severe cases.

What is the primary cause of UTIs?

The primary cause of most UTIs is bacteria, such as Escherichia coli.

What is a UTI?

A UTI is an infection that occurs when harmful microorganisms invade parts of the urinary system, causing inflammation and discomfort. Because there are several types of bacteria that cause UTIs, treatment usually involves antibiotics based on sensitivity testing results.



UTIs are prevalent worldwide, affecting millions of individuals annually. Women, especially sexually active young women, bear a higher burden of UTIs. Still, other populations, such as older adults and those with urinary tract procedures or catheters, are also susceptible.

UTIs contribute significantly to healthcare visits, emergency department visits, and hospitalizations, resulting in substantial costs. Because of this, prevention, good hygiene practices, and prompt diagnosis and treatment are vital in managing UTIs and reducing complications.

Ongoing research and efforts aim to develop preventive measures, including a potential UTI vaccine. Until then, raising awareness, promoting prevention, and prioritizing effective management can reduce the impact of UTIs on individuals’ health and well-being.


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Chandana Balasubramanian

Chandana Balasubramanian is an experienced healthcare executive who writes on the intersection of healthcare and technology. She is the President of Global Insight Advisory Network, and has a Masters degree in Biomedical Engineering from the University of Wisconsin-Madison, USA.

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