Urinary tract infection
What is a urinary tract infection?
A urinary tract infection (UTI) is a bacterial infection of the urinary tract (the bladder, kidney and prostate).
What are the complaints associated with a urinary tract infection?
The complaints are: pain or a burning sensation when urinating, more frequent urination, abnormal urge, blood in urine, pain in the back or lower abdomen, possible fever, chills, general malaise and pain in the sides or in the perineum (the area between the genitals and the anus). In people who are particularly susceptible, such as elderly people, people with dementia, sensory disorders or polypharmacy, urinary tract infections are associated with an increased risk of delirium: a reduction in consciousness involving disorientation, delusions and hallucinations, usually with, but sometimes without, agitation.
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People with intellectual disabilities sometimes find it impossible to communicate their pain and illness. The people around them may then notice only a change in behaviour or a delirium.
How common are urinary tract infections in the general population?
Urinary tract infections occur in 4% of the population annually.
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How common are urinary tract infections in people with intellectual disabilities?
An Australian survey of 2540 people with intellectual disabilities (in which questionnaires were answered by carers and parents) found that 22% of the study sample had urinary tract infections.
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A study of 1196 adults with intellectual disabilities but without spasticity found that 16% had urinary tract infections. People with intellectual disabilities and spasticity actually have a significantly higher risk of urinary tract infections (26%) than people with intellectual disabilities only.
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A prevalence rate of 20% was found for urinary tract infections in 51 children with intellectual disabilities. This was not significantly higher than the prevalence of 8% in the control group of 36 children without intellectual disabilities. However, urinary incontinence and urinary difficulties were significantly more common in the children with intellectual disabilities.
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A survey of 255 people with moderate to very severe intellectual disabilities receiving specialist care from Dutch healthcare organizations found that a quarter had 'asymptomatic bacteriuria'. In other words, there were bacteria in the urine but no complaints or observations of behaviour change by the staff.
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567Kleinveld WB, van der Vegte KE, van de Weerd G, Zalmstra TAL, Schuurman JP. Waarde van urinescreening voor urineweginfecties bij verstandelijk beperkte mensen. Nederlands Tijdschrift voor Zorg aan mensen met verstandelijke beperkingen. 2015;(2):110-2.
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