What Are the Primary Causes and Potential Complications of Urinary Tract Infections?
Urinary tract infections (UTIs) are one of the most common health conditions globally, with at least half of women affected by one or more UTIs during their lifetime.1 While UTIs are about 3.6 times more common in women than men, they tend to be more complicated when they occur in men.
Such was the case for U.S. Defense Secretary Lloyd Austin, who was hospitalized for a UTI that developed after he had prostate cancer surgery.2 While he’s expected to make a full recovery, deaths from UTIs increased by 2.4-fold from 1990 to 2019.
Globally, they cause a significant burden to health systems and public health, while reducing quality of life in individuals. In 2019 alone, there were 404.61 million cases of UTI worldwide, along with 236,790 deaths.3
What Causes Most UTIs?
About 80% to 90% of the time, UTIs are caused by E. coli bacteria,4 which can be introduced into your urinary tract in a number of ways, such as via your own feces or during sexual intercourse. The urethra, which carries urine out of your body from your bladder, is much shorter in women than in men, which is one reason why women tend to get more UTIs.
“It’s much more difficult for bacteria to work all the way up to the bladder” in men, Marisa Clifton, the director of women’s health for the Brady Urological Institute of the Johns Hopkins University School of Medicine, told The Washington Post.5 But this is just one contributing factor to UTIs.
Risk of UTIs increases with age, particularly after the age of 60.6 Kidney stones also make UTIs more likely, as does benign prostate enlargement in men, which may cause an inability to completely empty the bladder, increasing infection risk. In women, changes in estrogen levels after menopause may alter bacterial growth, making UTIs more likely.7
Another reason why UTIs tend to have such a high recurrence rate in postmenopausal women is because the infection can be caused by several different pathogens. According to research published in the Journal of Molecular Biology, data uncovered via urine and bladder biopsies “suggest that diverse bacterial species and the adaptive immune response play important roles” in recurrent UTIs.8
In this population, bacteria may form communities deep within the bladder wall, triggering chronic inflammation and making treatment difficult. Exposure to antibiotic-resistant bacteria in hospitals is another driving factor in UTIs. In health care facilities, up to 9.4% of patients may develop healthcare-associated UTIs, which can be deadly.
Among hospitalized patients, UTIs have a mortality rate of 2.3% along with associated annual costs of $340 million to $450 million annually in the U.S.9 While E. coli remains the most common cause of UTIs, including recurrent UTIs, other common UTI pathogens include:10
- Klebsiella pneumoniae
- Enterococcus faecalis
- Proteus mirabilis
- Staphylococcus spp.
- Group B Streptococcus
- Pseudomonas aeruginosa
UTIs May Be a Foodborne Illness Linked to Chicken
E. coli is normally found in the intestinal tract.11 Problems only arise when these ordinary bacteria are present in high numbers in places where they shouldn’t be, like your urinary system. Conventional wisdom has maintained UTIs are primarily caused by a transfer of naturally occurring E. coli via sexual contact with an infected individual and/or the transfer of fecal bacteria from your anus to your urethra by poor personal hygiene.
However, more recent studies have conclusively demonstrated that a majority of UTIs are actually caused by exposure to contaminated chicken.12 In short, it’s likely that UTI-causing E. coli may also be introduced to your body from the food you eat, namely CAFO (concentrated animal feeding operation) chicken, as well as pork and beef.
One study involved 2,460 chicken, pork and turkey samples purchased from large retail stores in Flagstaff, Arizona, nearly 80% of which were found to contain E. coli.13 The researchers also tested blood and urine samples from people who visited a major medical center in the area, finding E. coli in 72.4% of those diagnosed with a UTI.
In particular, a strain of E. coli known as E. coli ST131 showed up in both the meat samples, particularly poultry, and the human UTI samples. Most of the E. coli in the poultry was a variety known as ST131-H22, which is known to thrive in b
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