Urinary tract infections only rarely give rise to sepsis

About 60% of U.S. women experience UTIs at some point, but they are routinely, and successfully, treated with antibiotics. 

Actress Tanya Roberts of "James Bond" and "Charlie's Angels" fame died in January of sepsis that had stemmed from a urinary tract infection (UTI). Questions naturally arose about how typical such outcomes are with this common condition. The answer: not at all common.

“When something like this gets into the media, then so many women think, 'Oh my gosh, I have urinary tract infections. What does this mean for me? Will I get septic? And will I die?'” said Dr. Suzette Sutherland, director of female urology of the University of Washington School of Medicine.

The vast majority of urinary tract infections do not develop into full-blown sepsis, Sutherland said. But urospesis can happen, especially among older patients or those with compromised immune systems. 

A UTI is a bacterial or fungal infection along the urinary tract, most commonly in the bladder. The most typical symptom is the frequent urge to pee, as well as the feeling of the bladder not fully emptying. Urination can be painful and urine can be cloudy, tinged with blood or have a strong odor.

It is a common infection: About 60% of U.S. women and 10% of men will experience at UTI at some point in their lives.  Most infections are mild and treated at home or in an outpatient basis. Antibiotics are typically effective, but it is important to get a urine culture to confirm the infection and to identify the bug and the appropriate treatment.

For milder infections and infections caught at an early stage, doctors may recommend fluid intake as a first line of defense.

“One of the number one reasons that people get urinary tract infections is they're just not drinking enough fluids and keeping their urinary tract flushed. The general recommendation is 2 liters of fluid a day,” Sutherland said.

Let the color of your urine be your guide, she added.  If your urine is light yellow, you're good. If it looks like water, you're drinking more than you need. If your urine is a deeper golden color, you're not drinking enough.

Keeping your gut healthy is also a way to avoid UTIs, by consuming probiotics or eating foods that encourage healthy gut biomes and, for women, vaginal biomes. Topical estrogen, available in cream, suppository and ring applications, also can help maintain a good balance of vaginal bacteria. 

“You want to encourage a good bug, called lactobacillus, and vaginal estrogen is helpful in this regard,” Sutherland said.

For people with recurrent UTIs, Sutherland recommends cranberry supplements, which prevent the bacteria from clinging to the side of the bladder wall.  The active component in the cranberry juice is proanthocyanidins (PAC) but supplements need a potency of at least 30-35 mg of PAC, and it should be the bioactive form made from the juice of the cranberry. 

People with UTIs experiencing a high fever and/or pain in the upper back should call their provider for an immediate appointment. Upper back pain may indicate a kidney infection, which warrants prompt attention and treatment. In any case, if symptoms emerge, don't hesitate to contact a care provider.  “During the COVID-19 pandemic, we have seen many instances of delays in seeking medical care,” Sutherland added.

Barbara Clements, 253.740.5043, bac60@uw.edu

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