Urosepsis occurs when an infection moves from the urinary tract into the bloodstream. Bacteria can enter the urinary tract system through the urethra (the tube through which urine leaves the body) and cause an infection to develop. If the infection goes unnoticed or untreated, bacteria can multiply and infect the bloodstream in a very serious condition known as sepsis. Urosepsis occurs when sepsis impacts structures of the urinary tract.
As a person's body tries to fight the infection, it can cause a rapid heartbeat, as well as fever, chills, and confusion, and ultimately organ failure or even death. Knowing the risk factors and recognizing early symptoms can be vital.
Causes and Risk Factors for Urosepsis
A urinary tract infection (UTI) is the most common cause of urosepsis. It typically starts when bacteria—most often E. coli—enter the urinary tract via the urethra, travel to the bladder and then to the kidneys. Because bacteria multiply very quickly, and because the kidneys are in direct contact with blood as they filter it, an untreated UTI-turned-kidney infection allows bacteria to spread to the bloodstream.
Women are more likely to experience a UTI, because their anatomy allows bacteria to more easily access the urethra.
Other risk factors for urosepsis include:
- Fecal incontinence
- Urinary retention or difficulty fully emptying the bladder
- Recent urinary tract surgery
- Urinary tract obstruction, such as kidney stones, enlarged prostate, or urinary tract scarring
- Improper urinary catheter insertion that leads to a bacterial infection
Symptoms and Complications of Urosepsis
When bacteria enter the bloodstream, the body and its organs are driven into overload as they attempt to fight off the infection. This may cause:
- Rapid heartbeat
- Rapid breathing
- Fever
- Chills
- Anxiety
- Little to no urine output
- Loss of consciousness
- Dizziness
- Inability to focus
- Scarring of the urinary tract
- Organ failure
- Septic shock
Since urosepsis typically begins as a urinary tract infection, it is important to recognize those symptoms as well to prevent the condition from occurring.
Diagnosing Urosepsis
Physicians will conduct a physical examination so as to assess blood pressure, temperature, and check for a urinary tract infection.
Other tests include:
- Blood cultures use venous blood to test for bacteria
- Blood gases test arterial blood for pH, oxygen, and carbon dioxide leves
- Complete blood count: If urosepsis is present, a CBC will show elevated white cells. When this occurs, the lab will continue to incubate the patient's blood and if after five days there are bacteria present, a patient is considered septic.
- Clotting studies, such as a prothrombin time (PT) and partial thromboplastin time (PTT), test a patient's blood clotting. Sepsis can interfere with production of clotting factors, which can lead to bleeding.
- Cerebral spinal fluid (CSF) culture uses a needle to extract some of the fluid that moves in the space around the spinal cord. This is examined in the laboratory for bacteria, fungus, and viruses.
- Platelet count: If low, this can indicate a life-threatening complication of urosepsis known as disseminated intravascular coagulation.
- Urine culture: a urine sample is collected and examined for bacteria
Urosepsis Treatments
Since urosepsis is the result of bacteria that has entered the bloodstream, broad-spectrum antibiotics are typically the first line of treatment for urosepsis and are used until a urine culture or analysis has identified the bacterial strain that's causing the infection. Then, a more targeted antibiotic is prescribed. Blood transfusions may also be necessary depending on the severity of the condition and how much of the blood has been tainted.
References:
Urinary tract infection. (2010). National Women's Health Resource Center.
