Urinary tract infection is one of the most common infections of humans, resulting in significant morbidity and mortality. Females are more commonly affected than males, and both sexes are particularly more vulnerable at both extremes of age.
What causes UTIs?
The mechanism of Urinary Tract Infections (UTI) is almost always ascending bacterial infections, i.e., the microorganisms enter the urethra and urinary tract from outside through the urinary opening. Then they proliferate inside the urinary tract and cause inflammation and damage to the urinary tract, resulting in characteristic symptoms like burning micturition, increased frequency, urinary urgency, bleeding from the urinary tract, etc.
UTI Diagnosis
The diagnosis of UTI is comparatively straightforward with urine analysis and culture. Occasionally few other blood tests and radiological investigations might be required for a complete study of the disease. Apart from confirming the diagnosis. Urine culture also helps in identifying the causative organism and its susceptibility to different antibiotics commonly used for the treatment.
UTI Treatment
Dr Manas Ranjan Pradhan, Sr Consultant - Urologist at Manipal Hospital, Bhubaneswar, says that the mainstay of treatment for UTI is antibiotics along with other supportive therapy. The antibiotics kill and eradicate the causative bacteria from the urinary tract.
However, like all other organisms on this planet, the bacteria are fighting and evolving every day for their survival and adopting different mechanisms to protect themselves from these antibiotic medications. With frequent mutations and changes in their genetic material, the bacteria find and develop different ways to protect themselves from being killed by these antibiotics.
Increasing Risk of Antibiotic Resistance
When we start a patient with a UTI on antibiotics, about 70-85% of bacteria get killed within the first 1- 2 days, and the remaining ones get eradicated slowly. Also, like toxins, antibiotics are able to kill the bacteria only at or above a certain level or concentration. Therefore, the dosage and duration of a particular antibiotic treatment are very crucial for complete eradication of the offending microorganism. Suboptimal dosage or short treatment duration always leaves behind a few bacteria that are not killed despite being exposed to the antibiotics. Subsequently, these bacteria, as a survival strategy, develop mechanisms to find escape ways from getting killed by that particular drug. Either they change their outer body covering in such a way that the drug is unable to enter them, or they start synthesising a chemical in their body which degrades and destroys the particular antibiotic. These are the two main mechanisms by which the bacteria develop resistance to antibiotic drugs.
Inadequate dosage and suboptimal duration of antibiotic drug therapy are the main reasons behind the development of antibiotic resistance. Prolonged and unnecessary usage of antibiotics also results in the development of antibiotic resistance. Many patients themselves stop using the prescribed antibiotics after 2-3 days of therapy, after symptomatic relief! This is one of the main reasons for the development of drug resistance and should never be done.
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