Is Your Recurrent UTI Caused by a Relapse or a Reinfection?

If you’re suffering from recurrent UTI, it is crucial to determine whether it is caused by a relapse or a reinfection. That way, your doctor can recommend a more effective treatment course.

It is estimated that around 50% to 60% of females will contract a urinary tract infection at some point in their lives. Out of this number, 25% to 30% are likely to experience another infection within a year. At the same time, 3% to 5% will experience an ongoing, recurrent UTI.

These figures are quite concerning, as ailments in the urinary tract may lead to more worrisome conditions. For instance, what may start out as a seemingly uncomplicated case of cystitis may grow into a kidney infection (or pyelonephritis) if not successfully treated. In addition, UTIs may also be linked to sensitive conditions like diabetes or they may complicate a woman’s pregnancy.

Therefore, if your UTI keeps coming back, do not just write it off as a simple illness that will go away on its own. The first thing you need to find out, with the aid of your doctor, is whether a recurrent UTI is caused by a relapse or a reinfection.

Relapse vs reinfection: what’s the difference?

It is usually difficult to differentiate between the two by just looking at the symptoms you are experiencing. Women with a relapsing UTI have a recurring bacteriuria (or presence of bacteria in the urine) that is caused by the same microorganisms found before the previous treatment course. These bacteria do not necessarily grow between treatment rounds, and often resurface within two weeks.

Now, here is why a relapsing UTI is dangerous: Often, if a UTI keeps coming back, the most probable cause would be an undiagnosed and silent pyelonephritis. The problem with this, however, is that a silent pyelonephritis may present with symptoms similar to those of bladder infection or cystitis, making diagnosis even more difficult.

In addition, a relapse may also be caused by a persistent strain of bacteria that has invaded a woman’s genital, perineal, and rectal areas. Some habits, such as sexual or hygiene-related activities, may be repeatedly introducing these bacteria into the urinary tract, which therefore causes the relapse.

A reinfection, on the other hand, is usually brought about by a new episode of bacteriuria that is caused by a different strain of bacteria. There are other cases, however, when a reinfection happens due to the same microorganisms that caused your previous UTI. In such cases, it becomes even trickier to make the right diagnosis. However, a reinfection usually happens around one month after a UTI case (as opposed to the typical two-week interval between a relapsing UTI). During this one-month interval, the patient is symptom-free and there is no bacterial growth in the urine.

Managing a recurrent UTI

For women experiencing recurrent UTIs, it is important to clarify whether a relapse or a reinfection is occurring, as the management and treatment methods largely differ between the two conditions. Although no test is specific or sensitive enough to isolate the nature of a recurrent UTI, additional tests can be conducted to determine the right management methods for a patient’s case. For instance, your doctor may carry out a urine culture examination in order to identify the microorganisms that are causing the infection. This is a typical method used to pinpoint the root cause behind a stubborn UTI.

Antibiotics that target kidney infections may be more effective against relapsing UTIs. For reinfection cases, on the other hand, doctors may prescribe a one-dose antibiotic for UTI, especially among women whose urinary complaints are associated with sexual activities.

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