We have a serious UTI problem in Canada. Almost every female will experience one in their lifetime, and many of those will experience ongoing adverse effects due to the issues around diagnosing and treating UTIs.
In Alberta Health Services acute care facilities, over 4,500 patients are admitted every year with a UTI diagnosis. In 2019, there were more than 28,000 emergency room visits attributed to UTIs in Alberta; it is the fourth most common diagnosis for patients presenting in emergency rooms.
Doctors take several different approaches to diagnose UTIs in Canada, and the efficacy is questionable. Experts say the commonly used dipstick testing—where a plastic strip treated with chemicals is dipped into a urine sample, immediately indicating normal or abnormal levels—is at least 75 per cent inaccurate, and currently, no evidence-based consensus exists regarding the use of the commonplace microscopic exams—where a urine sample is looked at under a microscope.
Canada’s new guidelines for diagnosing and treating recurrent UTIs in women push to add urine culture testing to make a diagnosis. In this test, a urine sample is given several days to see if bacteria will grow in a lab setting and is then examined under a microscope. However, the accuracy of culture results leaves much to be desired.
One out of every five times the urine culture test reports a false negative. Research out of the United Kingdom has shown not only is this test unreliable but the false results can lead to a misdiagnosis and unnecessary treatments.
UTIs have the perfect symptom camouflage, its commonality and how it presents as a variety of other illnesses can make it difficult to see.
Another issue with recurring UTIs is how antibiotics are used to treat them.
The guidelines suggest for recurrent, acute UTI that antibiotics should be administered for as few days as possible to avoid resistance, but long enough to kill the bacteria.
Part of the problem is patients going on and off antibiotics; this can lead to the bacteria building up a resistance to the medication over time, eventually making it ineffective.
A treatment used in the United Kingdom for patients with chronic UTIs involves the long-term use of antibiotics.
The symptoms varie as much as the diagnosis and treatment. From the cliche burning sensation to running to the bathroom up to 30 times per hour. It could mean an emergency trip to the hospital or a lifetime of isolation.
The recurrent, uncomplicated urinary tract infection is extremely common in Canada. Somewhere around eight to 10 per cent of women will have rUTIs. It’s also the most common use of antibiotics for Canadian women. But antibiotics cause a lot of damage, not only to the individual but also to society, through the creation of resistant organisms, said Dr. Nickel.