Urinary Tract Infection is more likely to occur in young women especially those who are sexually active or pregnant, which puts them at a higher risk for the infection. It can be a single-episode of Urinary Tract Infection or a recurrent UTI. The incidences of Enterococcus faecalis and Escherichia coli shows to be significantly higher in patients with infection than those who had single-episode urinary tract infection. E. faecalis is known to be the most common and make structural changes. Adherent E. coli is also more likely to have an important role in the etiology of young women who have recurrent UTI. Both of these bacteria are known to cause mild to serious diseases. So the question is, what clinical signs and symptoms will distinguish recurrent UTI from a single-episode UTI?
Hello Beatriz Gicole
Your research about the causative organisms sounds very interesting but I am not sure whether my non micro-organism response is what you were hoping for.
If I saw someone with recurrent UTIs, I would want to identify some other reason, if there was one; e.g. pain in the kidney region etc., a history of diabetes or if s/he was immunocompromised . . or previous urethral catheterisation. And would refer on (where necessary). The sexual history might be relevant.
I used to do a bladder scan to see if the cause was a residual urine more than 100ml and I would further investigate it and treat / refer on. He / she might complain of voiding problems including difficulty in starting a void (although there may have been the feeling of urgency), and report straining, poor stream, the feeling of incomplete emptying and the need to re-void and post micturition urinary incontinence.
If the recurrent UTIs were in a woman past the age of menopause, I used to ask her if she had symptoms of atrophic vaginitis (dryness, discomfort or using lubricating gel for sexual intercourse) or if I saw a dry red smooth vagina (or alternatively paler) when I examined the woman. Again, I would treat or refer on.
If it was an older woman with faecal incontinence, I would look to see if there was faecal soiling constantly round the urethral orifice. With atrophic changes, the urethral walls may not provide such a good barrier as they do in younger women. In addition, if, due to physical disability, the woman cleans her anal areas from the front, wiping the faeces from the anus, forward, contaminating the vagina and the urethral orifice, this could also sometimes cause recurrent UTIs. In this case, I would discuss / help with hygiene and also look into the faecal problems.
I hope this is helpful; these are things that I remember, but no doubt, other RG members will supplement my memories (and I will probably think 'yes, I forgot that!')
Mary
Hello again, Beatriz Gicole
I noticed that someone from the same university as you had posed a similar question. You have probably seen it, but Marvin Lloyd Reves Estabillo, also from your university gave a very good and detailed reply, that you might find relevant:
https://www.researchgate.net/post/Whats_the_different_species_of_bacteria_that_can_cause_UTI_and_does_the_severity_of_UTI_depends_on_the_species_of_bacteria_that_infect_the_patient
I agree with the excellent and comprehensive answers from Mary CR Wilson.
Just to add recurrent UTI's occurring in the context of an incomplete course of antibiotics, and /or resistance to the prescribed antibiotic, anatomical bladder abnormalities (diverticulae, calculus), functional -vesico-ureteric reflux, renal calyx- hydronephrosis, calculi, underlying co-morbidities (diabetes) and perimenopausal changes in estrogen levels.
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