Sometimes it becomes very difficult to diagnose whether a person is suffering from Urinary Tract Infections (UTI) or Sexually Transmitted Disease (STD) like Chlamydia infections. UTI or cystitis are infections which occurs in any parts of the urinary tract including kidney, ureters, urinary bladder, urethra and opening of genitalia. It is referred to as lower UTI when urinary bladder, urethra and opening of genitalia are affected. Infections in kidney (pyelonephritis) or ureters are called upper UTI. The symptoms from lower UTI include pain or burning sensation while passing urine, frequency of urination increases, urinary incontinence (lack of control over urination) occurs. Sometimes hematuria (blood in urine) may also occur along with presence of pus cells. While, the symptoms of upper UTI include fever, flank pain in addition to symptoms of lower UTI.
The chief causative organism for the disease is a bacterium called Escherichia coli; however viruses and fungi may be rarely involved. E.Coli resides in the gastrointestinal tract of human beings, and as the distance between the anus and the external genitalia is short in females, compared to males, females are more prone to UTIs. Apart from anatomical factors, the other risk factors include sexual intercourse, insertion of catheters in urinary tract and family history. Urine culture or prostrate profiling is often done to diagnose the causative pathogen. The culture is considered positive if the bacterial count increases more than 103 colony forming unit/ ml. The treatment of UTI involves administration of antibiotics like norfloxacin or ciprofloxacin which have effective coverage against gram negative bacteria like E.Coli. Maintenance of proper hygiene like changing the undergarments every day and cleaning the uro-genital tract are some prevention measures. It is also suggested intake of cranberry juices may reduce the frequency of UTI. The prognosis of UTI is usually good, however in certain cases untreated UTI may lead to septicaemia or infection of the blood. This can lead to systemic infections causing end organ failure. In such cases high generation and injectable antibiotics are used. If bleeding continues, the individual must be screened for cancer of the urinary bladder.
Chlamydia infections are the commonest sexually transmitted infections caused by the bacterium Chlamydia trachomatis. However any infection caused by the family of bacteria Chlamydiaceae may be termed Chlamydia infections. The bacterium resides in the normal cells of our body and is transmitted through vaginal, oral or anal sex. The disease may be passed on to the foetus. Chlamydia infections occur in the cervix of women and urethra in case of men. The infections are asymptomatic and hence there is absence of any burning sensation during urination. The infection can spread up to the upper genital tract and women and cause Pelvic inflammatory Diseases. Same can happen in men and causes epididymal infection. The bacterium may also lead to conjunctivitis or trachomitis, which might cause blindness.
The bacterium may also cause reactive arthritis and spontaneous abortions. The bacterium utilizes vitamins and amino acids of host cells for their growth and multiplication. Once the cells are devoid of such nutrients, the bacterium halts its growth, however when favourable supply of nutrients reappear, the bacterium multiplies and causes recurrent infections. Nucleic Acid Amplification Tests on the swap collected from cervix or prepuce helps to diagnose Chlamydia infections. Antibiotics like azithromycin and doxycycline are used to treat Chlamydia infections. A comparison of UTI and Chlamydia infection is reflected below:
|Site of Occurrence||Infections in urinary bladder and urinary tract||sexually transmitted infections occurring in cervix and genital tracts of male and female, and also eyes|
|Transmitted by sex||Not usually||Always|
|Causative pathogen||E.coli||C. trachomatis|
|Symptoms||Fever, hematuria, burning sensation while passing urine||Asymptomatic|
|Presence of white discharge||Never||May occur|
|Transmission risk to foetus||No||Yes|
|Dormancy of bacterium||Never||Yes( when conditions are not favourable)|
|Treatment Antibiotics||Ofloxacin & Norfloxacin||Azithromycin & Doxycycline|
|Diagnosis||Urine culture||NAAT tests from swab of cervix|
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