Dental or medical procedures can lead to bacteremia. During dental procedures as during tooth cleaning by a dental hygienist , bacteria living on the gums may become dislodged and enter the bloodstream. Bacteremia may also occur when catheters are inserted into the bladder or tubes are inserted into the digestive tract or urinary tract.
Bacteria may be present in the area where the catheter or tube has been inserted such as the bladder or intestine. So even though sterile techniques are used, these procedures may move bacteria into the bloodstream. Surgical treatment of infected wounds, abscesses collections of pus , and pressure sores can dislodge bacteria from the infected site, causing bacteremia. In some bacterial infections , such as pneumonia and skin abscesses , bacteria may periodically enter the bloodstream, causing bacteremia.
Seven ways to treat a UTI without antibiotics
Many common childhood bacterial infections cause bacteremia. Injecting recreational drugs can cause bacteremia because the needles used are usually contaminated with bacteria, and people often do not properly clean their skin. Usually, bacteremia that results from ordinary events, such as dental procedures, is temporary and causes no symptoms. Bacteremia that results from other conditions may cause fever.
If bacteremia, sepsis, or septic shock is suspected, doctors usually take a sample of blood so they can try to grow culture the bacteria in the laboratory and identify it. If needed, doctors may try to culture bacteria from other samples such as urine or sputum.
People who are at high risk of complications due to bacteremia such as those who have an artificial heart valve or joint or certain heart valve abnormalities are often given antibiotics before procedures that can cause bacteremia:. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
The Merck Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. Common Health Topics. The most common cause of infection is Escherichia coli , though other bacteria or fungi may rarely be the cause. Lower urinary tract infection is also referred to as a bladder infection.
Urine Flow Test
The most common symptoms are burning with urination and having to urinate frequently or an urge to urinate in the absence of vaginal discharge and significant pain. People experiencing an upper urinary tract infection, or pyelonephritis , may experience flank pain , fever , or nausea and vomiting in addition to the classic symptoms of a lower urinary tract infection. In young children, the only symptom of a urinary tract infection UTI may be a fever. Because of the lack of more obvious symptoms, when females under the age of two or uncircumcised males less than a year exhibit a fever, a culture of the urine is recommended by many medical associations.
Infants may feed poorly, vomit, sleep more, or show signs of jaundice. In older children, new onset urinary incontinence loss of bladder control may occur.
Urinary tract symptoms are frequently lacking in the elderly. It is reasonable to obtain a urine culture in those with signs of systemic infection that may be unable to report urinary symptoms, such as when advanced dementia is present. Uropathogenic E. In post-menopausal women, sexual activity does not affect the risk of developing a UTI. Women are more prone to UTIs than men because, in females, the urethra is much shorter and closer to the anus. Risk of infections increases as males age.
While bacteria is commonly present in the urine of older males this does not appear to affect the risk of urinary tract infections.
Urinary catheterization increases the risk for urinary tract infections. The risk of bacteriuria bacteria in the urine is between three and six percent per day and prophylactic antibiotics are not effective in decreasing symptomatic infections. Male scuba divers using condom catheters and female divers using external catching devices for their dry suits are also susceptible to urinary tract infections. A predisposition for bladder infections may run in families.
Persons with spinal cord injury are at increased risk for urinary tract infection in part because of chronic use of catheter, and in part because of voiding dysfunction. The bacteria that cause urinary tract infections typically enter the bladder via the urethra. However, infection may also occur via the blood or lymph.
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Coli are able to attach to the bladder wall and form a biofilm that resists the body's immune response. Escherichia coli is the single most common microorganism, followed by Klebsiella and Proteus spp. Klebsiella and Proteus spp. The presence of Gram positive bacteria such as Enterococcus and Staphylococcus increased. The increased resistance of urinary pathogens to quinolone antibiotics has been reported worldwide and might be the consequence of overuse and misuse of quinolones. In straightforward cases, a diagnosis may be made and treatment given based on symptoms alone without further laboratory confirmation.
Urine culture is deemed positive if it shows a bacterial colony count of greater than or equal to 10 3 colony-forming units per mL of a typical urinary tract organism. Antibiotic sensitivity can also be tested with these cultures, making them useful in the selection of antibiotic treatment. However, women with negative cultures may still improve with antibiotic treatment.
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A urinary tract infection may involve only the lower urinary tract, in which case it is known as a bladder infection. Alternatively, it may involve the upper urinary tract, in which case it is known as pyelonephritis. If the urine contains significant bacteria but there are no symptoms, the condition is known as asymptomatic bacteriuria. To make the diagnosis of a urinary tract infection in children, a positive urinary culture is required.
The use of "urine bags" to collect samples is discouraged by the World Health Organization due to the high rate of contamination when cultured, and catheterization is preferred in those not toilet trained. Some, such as the American Academy of Pediatrics recommends renal ultrasound and voiding cystourethrogram watching a person's urethra and urinary bladder with real time x-rays while they urinate in all children less than two years old who have had a urinary tract infection. However, because there is a lack of effective treatment if problems are found, others such as the National Institute for Health and Care Excellence only recommends routine imaging in those less than six months old or who have unusual findings.
In women with cervicitis inflammation of the cervix or vaginitis inflammation of the vagina and in young men with UTI symptoms, a Chlamydia trachomatis or Neisseria gonorrhoeae infection may be the cause. Vaginitis may also be due to a yeast infection. Hemorrhagic cystitis , characterized by blood in the urine , can occur secondary to a number of causes including: infections, radiation therapy , underlying cancer, medications and toxins.
A number of measures have not been confirmed to affect UTI frequency including: urinating immediately after intercourse, the type of underwear used, personal hygiene methods used after urinating or defecating , or whether a person typically bathes or showers. Using urinary catheters as little and as short of time as possible and appropriate care of the catheter when used prevents catheter-associated urinary tract infections.
For those with recurrent infections, taking a short course of antibiotics when each infection occurs is associated with the lowest antibiotic use. In cases where infections are related to intercourse, taking antibiotics afterwards may be useful. The evidence that preventive antibiotics decrease urinary tract infections in children is poor.
Some research suggests that cranberry juice or capsules may decrease the number of UTIs in those with frequent infections. The mainstay of treatment is antibiotics.
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Phenazopyridine is occasionally prescribed during the first few days in addition to antibiotics to help with the burning and urgency sometimes felt during a bladder infection. Those who have bacteria in the urine but no symptoms should not generally be treated with antibiotics.
Uncomplicated infections can be diagnosed and treated based on symptoms alone. Complicated UTIs are more difficult to treat and usually requires more aggressive evaluation, treatment and follow-up. Pyelonephritis is treated more aggressively than a simple bladder infection using either a longer course of oral antibiotics or intravenous antibiotics.
Urinary tract infections are the most frequent bacterial infection in women. Urinary tract infections occur four times more frequently in females than males. In the United States, urinary tract infections account for nearly seven million office visits, a million emergency department visits, and one hundred thousand hospitalizations every year.
In the United States the direct cost of treatment is estimated at 1. Urinary tract infections have been described since ancient times with the first documented description in the Ebers Papyrus dated to c. Urinary tract infections are more concerning in pregnancy due to the increased risk of kidney infections. During pregnancy, high progesterone levels elevate the risk of decreased muscle tone of the ureters and bladder, which leads to a greater likelihood of reflux, where urine flows back up the ureters and towards the kidneys.
Cephalexin or nitrofurantoin are typically used because they are generally considered safe in pregnancy. From Wikipedia, the free encyclopedia.
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