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Insights on urinary tract infections
04 Nov 2024
Insights on urinary tract infections
Posted on04 Nov 2024
The overall disease burden associated with UTIs has increased by more than 68 percent between 1990 and 2019. At the same time, the bacteria that cause UTIs have developed resistance to common drugs. More than 400 million annual worldwide UTI cases significantly strain limited medical resources.
"We know UTIs are a tremendous cause of morbidity and even mortality, but they are also a huge burden on the U.S. healthcare system—contributing to well over $2 billion annually in healthcare costs," says Michelle Van Kuiken, a urologist and a urogynecologist at the University of California, San Francisco.
Working to ease this burden, scientists have been seeking to identify and understand lesser-known contributing factors. One culprit may come as a surprise: meat contaminated by Escherichia coli bacteria.
What are UTIs and how dangerous are they?
UTIs can start in any part of the urinary system and can affect the kidneys, bloodstream, and uterus, but they most commonly infect the bladder "with symptoms of urinary frequency, urgency to urinate (sometimes despite having an empty bladder), and burning during urination," says Craig Comiter, a urologist at Stanford University.
Cramping, fever, malodor, and blood in the urine can also be signs of a bladder infection. UTIs occur when bacteria enter the urethra and infect the urinary tract—something that can occur during sexual activity, because of a genetic predisposition, or due to poor hygiene practices such as not wiping properly.
UTIs are the most common infection treated outside of hospitals in the United States, affecting some 50-60 percent of women during their lifetime. Roughly a quarter of women also report repeat infections within six months. While UTIs can happen to anyone, they are about 30 times more common in women because females have shorter urethras that are closer in proximity to the anus—a common source of bacteria.
Why are the number of UTIs increasing?
The increasing number of UTI cases are due to several factors, one of which is a burgeoning population. "As the population increases, we expect more UTIs and more [of the disease burden associated with] UTIs because there are more people," says Lazarus.
On top of that, some of the conditions associated with UTIs, such as kidney stones and type 2 diabetes, are also on the rise. And a high number of teens and adults are sexually active. "In otherwise healthy women, sexual activity is the number one contributor to developing a UTI," says Van Kuiken.
The global population is also getting older. "Because UTIs are more common in seniors, their prevalence is increasing as the population ages," says Comiter. Cindy Liu, a microbiologist and the chief medical officer at the Antibiotic Resistance Action Center at George Washington University’s Milken Institute School of Public Health, cites another compelling factor behind the rising numbers of more dangerous infections: an increase in antibiotic-resistant UTIs.
"Without changing how we use our antibiotics, we are on track to have fewer options for treating bladder, kidney, and urosepsis infections," she says.
The part meat plays Meat consumption plays a part in all this in two distinct ways: by introducing infection-causing bacteria to the urethra, and because many of the antibiotics introduced in meat sources can end up increasing resistance to the medications that could kill the infection once it begins.
Healthy farm animals in the U.S. and elsewhere often receive antibiotics for disease protection, a practice known to drive antibiotic resistance. Comiter cites "the overuse of these antibiotics in animal husbandry" as one significant reason more and more people are developing resistance to the antibiotics used to treat UTIs.
"Eating meat that has been heavily treated with antibiotics may be contributing to increasing rates of antibiotic resistance as the human microbiome is being influenced by meat consumption," echoes Van Kuiken. "This does not mean that if you eat meat, you are going to get a UTI, but it could increase the likelihood that you may end up colonized with a multi-drug resistant organism.
"Drug-resistant or not, E. coli from meat can colonize your gut and spread to your urinary tract. This can occur in women after the contaminated meat passes through the digestive system and is excreted in close proximity to the vaginal wall, where the bacteria has only a short distance to travel between the anus and the entrance of the urethra.
A 2023 study estimates that contaminated meat causes nearly half a million UTIs in the United States annually—a small fraction of the more than eight million UTI-related healthcare visits in the country each year, but enough to merit concern. Especially so because "30 to 70 percent of our retail meat products have been shown to be contaminated with E. coli," says Liu, who co-authored the 2023 research.
The power of pure cranberry - Generally, the majority of studies suggest that cranberry helps with preventing and treating recurrent UTIs in women.
In 2021, a review concluded that cranberry significantly reduced the risk of recurrent UTIs in women by 32%. The American Urological Association (AUA) and the European Association of Urology (EAU) recommend cranberry as non-antibiotic treatment in preventing recurrent UTIs.
Probiotics and the urinary microbiota- Studies have shown that the urinary microbiota differs between healthy people and those with urologic diseases. Probiotics may help regulate the urinary microbiota and reduce the risk of UTIs.
Source: National Geographic 2024 (Aug Issue).
"We know UTIs are a tremendous cause of morbidity and even mortality, but they are also a huge burden on the U.S. healthcare system—contributing to well over $2 billion annually in healthcare costs," says Michelle Van Kuiken, a urologist and a urogynecologist at the University of California, San Francisco.
Working to ease this burden, scientists have been seeking to identify and understand lesser-known contributing factors. One culprit may come as a surprise: meat contaminated by Escherichia coli bacteria.
What are UTIs and how dangerous are they?
UTIs can start in any part of the urinary system and can affect the kidneys, bloodstream, and uterus, but they most commonly infect the bladder "with symptoms of urinary frequency, urgency to urinate (sometimes despite having an empty bladder), and burning during urination," says Craig Comiter, a urologist at Stanford University.
Cramping, fever, malodor, and blood in the urine can also be signs of a bladder infection. UTIs occur when bacteria enter the urethra and infect the urinary tract—something that can occur during sexual activity, because of a genetic predisposition, or due to poor hygiene practices such as not wiping properly.
UTIs are the most common infection treated outside of hospitals in the United States, affecting some 50-60 percent of women during their lifetime. Roughly a quarter of women also report repeat infections within six months. While UTIs can happen to anyone, they are about 30 times more common in women because females have shorter urethras that are closer in proximity to the anus—a common source of bacteria.
Why are the number of UTIs increasing?
The increasing number of UTI cases are due to several factors, one of which is a burgeoning population. "As the population increases, we expect more UTIs and more [of the disease burden associated with] UTIs because there are more people," says Lazarus.
On top of that, some of the conditions associated with UTIs, such as kidney stones and type 2 diabetes, are also on the rise. And a high number of teens and adults are sexually active. "In otherwise healthy women, sexual activity is the number one contributor to developing a UTI," says Van Kuiken.
The global population is also getting older. "Because UTIs are more common in seniors, their prevalence is increasing as the population ages," says Comiter. Cindy Liu, a microbiologist and the chief medical officer at the Antibiotic Resistance Action Center at George Washington University’s Milken Institute School of Public Health, cites another compelling factor behind the rising numbers of more dangerous infections: an increase in antibiotic-resistant UTIs.
"Without changing how we use our antibiotics, we are on track to have fewer options for treating bladder, kidney, and urosepsis infections," she says.
The part meat plays Meat consumption plays a part in all this in two distinct ways: by introducing infection-causing bacteria to the urethra, and because many of the antibiotics introduced in meat sources can end up increasing resistance to the medications that could kill the infection once it begins.
Healthy farm animals in the U.S. and elsewhere often receive antibiotics for disease protection, a practice known to drive antibiotic resistance. Comiter cites "the overuse of these antibiotics in animal husbandry" as one significant reason more and more people are developing resistance to the antibiotics used to treat UTIs.
"Eating meat that has been heavily treated with antibiotics may be contributing to increasing rates of antibiotic resistance as the human microbiome is being influenced by meat consumption," echoes Van Kuiken. "This does not mean that if you eat meat, you are going to get a UTI, but it could increase the likelihood that you may end up colonized with a multi-drug resistant organism.
"Drug-resistant or not, E. coli from meat can colonize your gut and spread to your urinary tract. This can occur in women after the contaminated meat passes through the digestive system and is excreted in close proximity to the vaginal wall, where the bacteria has only a short distance to travel between the anus and the entrance of the urethra.
A 2023 study estimates that contaminated meat causes nearly half a million UTIs in the United States annually—a small fraction of the more than eight million UTI-related healthcare visits in the country each year, but enough to merit concern. Especially so because "30 to 70 percent of our retail meat products have been shown to be contaminated with E. coli," says Liu, who co-authored the 2023 research.
The power of pure cranberry - Generally, the majority of studies suggest that cranberry helps with preventing and treating recurrent UTIs in women.
In 2021, a review concluded that cranberry significantly reduced the risk of recurrent UTIs in women by 32%. The American Urological Association (AUA) and the European Association of Urology (EAU) recommend cranberry as non-antibiotic treatment in preventing recurrent UTIs.
Probiotics and the urinary microbiota- Studies have shown that the urinary microbiota differs between healthy people and those with urologic diseases. Probiotics may help regulate the urinary microbiota and reduce the risk of UTIs.
Source: National Geographic 2024 (Aug Issue).