Urinary Tract Infections (UTIs) are a prevalent health concern. More than 50% of women experience UTI in their lifetime1, with 20% to 40% of those suffering recurrences and requiring multiple short and long-term dosing of antibiotics. UTI is characterised by symptoms like burning during urination, frequent urges to urinate, and lower abdominal pain. UTIs can be both painful and disruptive. Recurrent UTIs are defined as three or more UTIs during 12 months or 2 or more during 6 months. UTIs are also the most common infection in older adults and the leading infection requiring antibiotics in long-term care.
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In this article, we explore the causes of recurrent UTIs in women and examine the promising role of the UTI vaccine in its prevention.
Why are Women More Prone to Recurrent UTIs?
- Anatomy: The female urethra is shorter, allowing bacteria easier access to the bladder.
- Proximity to the anus: The urethral opening’s closeness to the anus can lead to the transfer of bacteria, especially E.coli.
- Catheterisation: pushes bacteria into the bladder causing colonisation of the bladder
- Antibiotics reduce vaginal lactobacilli: (the natural bacteria of the vagina that prevent colonisation by other bacteria)
- Sexual activity: Intercourse can introduce bacteria into the urinary tract. The use of spermicidal gel increases vaginal pH and makes women susceptible to UTIs
- Menopause: Reduced oestrogen levels can make the urinary tract more vulnerable to infections.
Poorly controlled diabetes
Click here to Book the Recurrent Urinary Tract Infection UTI Vaccine in The Health Suite Leicester.
The Vaccine: A Game-Changer in UTI Prevention
Over-the-counter (OTC) preparations and antibiotics have been the traditional go-to treatments for UTIs. Antibiotic stewardship recognises concerns about antibiotic resistance and their side effects have led to the search for alternative preventive measures. This is where the UTI vaccine comes into play.
What is the UTI Vaccine?
The UTI vaccine is an oral immunostimulant for the prevention of urinary tract infections. It works by stimulating the immune system by increasing resistance against urinary tract infections. The vaccine is composed of the inactivated whole bacteria of the four most common bugs causing UTIs: Klebsiella pneumoniae (25%), Escherichia coli (25%), Enterococcus faecalis (25%), and Proteus vulgaris (25%).
Rather than being injected, it is administered daily over three months via a pineapple-flavoured spray. Once administered it interacts with the immune system, resulting in long-term protection from UTIs in the patient.
Click here to Book the Recurrent Urinary Tract Infection UTI Vaccine in The Health Suite Leicester.
Whom is it recommended for?
The UTI vaccine is recommended for patients with symptomatic and confirmed recurrent urinary tract infections that have been diagnosed with microbiological testing of the urine. Patients should be aware of other conditions such as painful bladder syndrome (also known as interstitial cystitis) or kidney stones that are unlikely to respond to the UTI vaccine.
What’s the current evidence base for its use?
There have been several studies looking into the safety and efficacy of the UTI vaccine in preventing urinary tract infections. These have proved to be promising in the treatment of recurrent urinary tract infections with lasting effects for up to a year. It is currently available in the UK for use; however, it is still unlicensed.
Are there any risks to the treatment?
UTI vaccine is usually well tolerated with only a few patients describing adverse reactions such as a rash, itching or stomach upset.
References:
- Foxman B, Barlow R, D’Arcy H, et al. Self-reported incidence of urinary tract infection and associated costs. Ann Epidemiol 2000;10:509-15. DOI.
- Epp A, Larochelle. ASOGC clinical guidelines for UTI. J Obstet Gynaecol Can 2017;39:e422-31. DOI
- Nicolle, L. (2013). Urinary Tract Infection. In J. F. M. Nunez, J. S. Cameron & D. G. Oreopoulos (Eds.), The Aging Kidney in Health and Disease. London, United Kingdom: Spring Science+Business Media.
- https://www.bsac.org.uk/antimicrobialstewardshipebook/BSAC-AntimicrobialStewardship-FromPrinciplestoPractice-eBook.pdf
- BJU Int. 2018 Feb;121(2):289-292. doi: 10.1111/bju.14067. Epub 2017 Nov 23
Uromune vaccine was also mentioned in an article in The Telegraph, and Metro.
Click here to Book the Recurrent Urinary Tract Infection UTI Vaccine in The Health Suite Leicester.
Common Q&A about Recurrent UTIs in Women
A recurrent UTI is defined as having two or more UTIs within six months, or three or more in a year. These infections are caused by bacteria that affect the urinary system, including the bladder and urethra.
Recurrent UTIs are often caused by bacteria re-entering the urinary tract after initial treatment. Factors such as anatomy (a shorter urethra in women), sexual activity, menopause, use of spermicides, or improper wiping after using the toilet can increase the risk.
Common symptoms include a frequent urge to urinate, pain or burning during urination, cloudy or strong-smelling urine, and pelvic pain. If the infection reaches the kidneys, symptoms can include fever, back pain, and nausea.
Recurrent UTIs are diagnosed based on the frequency of infections and a urinalysis (urine test) to identify the bacteria responsible. A healthcare provider may also recommend imaging tests or a cystoscopy if infections are frequent or severe.
Yes, sexual activity can increase the risk of UTIs. This is because bacteria can be introduced into the urinary tract during intercourse. Using lubrication, urinating before and after sex, and avoiding spermicides may help reduce the risk.
Treatment typically involves antibiotics to clear the infection. In cases of recurrent UTIs, doctors may prescribe a low-dose antibiotic for an extended period, provide post-coital (after sex) antibiotics, or use self-start therapy where the woman takes antibiotics at the first sign of symptoms.
Yes, preventive measures include drinking plenty of water, urinating frequently, wiping from front to back, avoiding irritants like douches, wearing cotton underwear, and urinating after sexual intercourse to flush out bacteria.
Yes, menopause can lead to an increased risk of recurrent UTIs due to a decrease in estrogen, which thins the lining of the urinary tract and reduces its ability to fight infections. Vaginal estrogen therapy may be recommended for postmenopausal women to reduce this risk.
If left untreated, recurrent UTIs can lead to more serious kidney infections (pyelonephritis), which can cause permanent kidney damage or lead to sepsis, a life-threatening condition. Prompt treatment is essential to avoid complications.
You should see a doctor if you experience frequent UTIs (more than two infections within six months or three in a year), if symptoms do not improve with treatment, or if you have symptoms of a kidney infection (fever, back pain). A healthcare provider can evaluate underlying causes and recommend appropriate treatments.