Drug-Resistant Urinary Tract Infections Mean More Hospitalizations And Complications

Urinary tract infections, or UTIs, are among women's most common health complaints. But as bacteria become increasingly resistant to antibiotics, many of the frontline drugs for treating the infections are ineffective.

Here & Now's Robin Young talks with Dr. Jessica Shepherd (@JShepherd_MD), who specializes in women's health at Baylor University Medical Center.

On why women tend to develop urinary tract infections more than men

"What we see in women typically is that they actually will have more urinary tract infections than males, and that's because just the anatomy of the urethra and it has a little bit more access, I guess you can say, to the outside world than you would see in the male anatomy. Pregnancy is another reason why you would see more urinary tract infections as well. So many times it is due to something that was acquired in the genitourinary tract area. But now that we're seeing something that could be food-borne — especially when it comes to E. coli — can be a very big issue because that's something that we really haven't encountered before. And now looking at the treatments for that, that's where we have some of the issues."

On UTIs becoming resistant to antibiotics

"Some of the things that we've noticed since I guess ... the advent of penicillin, say, is that we typically know when there's an infection in a certain part of the body, we know what antibiotics are going to do really well with that infection, what's going to help clear them up. So now we're running into the issue not only of how you get the urinary tract infection, [but also] how you actually treat it. And so what we're finding is what we call [an] antibiotic resistance, and so that really encounters when we have antibiotics that are typical for treating a typical infection that's not working. And what we're seeing now is that as we start to have different types of urinary tract infections is now we're not having the antibiotics to cover those, and that's where we're incurring more of a problem and what we're seeing: more women being admitted to the hospital or having more severe urinary tract infections that can go all the way up to the kidney."

On finding out which drug will effectively treat the infection by growing a culture of the bacteria, which can take time

"Absolutely, and that's the difference between being able to treat when someone comes into the office with symptoms, or even if you do something as savvy as telemedicine and having those characteristic symptoms of a urinary tract infection. The issue now is, even if we do treat those over the phone, sending in a prescription for the patient, we can't get very good coverage because these antibiotics are not covering the urinary tract infection. So you had said something earlier about the bacteria changing, and the bacteria are actually very smart, and so when they have an antibiotic that they have that can push away that infection, when we have too many people who are taking antibiotics that are not for the intended use that it is, that's when bacteria can actually change its coding and therefore be resistant to the antibiotics that we use."

On some women winding up in the hospital because the infection has spread to their kidneys

"And even further — it can go beyond the kidneys. We can have someone who can go into sepsis who is not treated adequately for a simple urinary tract infection. So imagine someone having a urinary tract infection, having common symptoms, but the bacteria is not being covered by the antibiotic and it just gets a little bit worse. And that's what we need to be careful about, is that we're having hospital admissions that are now turning into sepsis, and that's going to even cause more antibiotic coverage and then patient safety."

On addressing a UTI by drinking cranberry juice

"That is not the cure for UTIs. We want to make sure that people are hydrating themselves. Cranberry juice actually has a lot of sugar, which can actually increase the risk of having a new urinary tract infection."

Karyn Miller-Medzon produced this interview and edited it for broadcast with Kathleen McKenna. Jack Mitchell adapted it for the web.