Surgery Recovery Overview of Urosepsis When Urinary Tract Infections Lead to Sepsis By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FN LinkedIn Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine. Learn about our editorial process Updated on January 22, 2022 Medically reviewed by Scott Sundick, MD Medically reviewed by Scott Sundick, MD LinkedIn Scott Sundick, MD, is a board-certified vascular and endovascular surgeon. He currently practices in Westfield, New Jersey. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents How It Develops UTI Symptoms Risk Factors for Urosepsis Treatment Urosepsis is a condition where a urinary tract infection (UTI) leads to a systemic infection that spreads throughout the body through the bloodstream. The severe effect of this systemic infection is referred to as sepsis. As many as 25% of individuals who develop sepsis are found to have had a UTI as the source of the condition. Urosepsis is very serious and can quickly become life-threatening. Even with rapid diagnosis and treatment, urosepsis can develop into an infection that is difficult to control with medication and supportive treatment. In the most severe cases, sepsis can lead to multi-system organ failure. Science Photo Library / Getty Images Development of Urosepsis A UTI is an infection that affects a portion of the urinary tract. The urinary tract includes the kidneys, the ureters, the bladder, and the urethra. An infection in any of these can cause discomfort, pain, the urge to urinate frequently, and a fever. Most UTIs are considered lower urinary tract infections and affect the bladder (cystitis) and urethra (urethritis). Kidney (pyelonephritis) and ureter infections are less common, and they are typically more severe and can be potentially more harmful than lower UTIs. Early identification of a UTI, along with proper treatment, is the best way to prevent urosepsis. It is possible to develop urosepsis without first having symptoms of a UTI or seeking treatment. UTI Symptoms There are common signs and symptoms of a UTI, and you can experience any combination of them. For example, some people may have a fever, while others can feel normal but may notice a change in the appearance of their urine. The most common signs and symptoms of a UTI include: Burning during urinationPelvic pain or pressureUrine with a strong odorFrequent urge to urinateDiscolored urine Symptoms of a Urinary Tract Infection Symptoms of urosepsis are similar to the symptoms of sepsis, and can include fevers, rapid heart rate, hypotension (low blood pressure), rapid breathing, and difficulty breathing. Risk Factors for Urosepsis Anyone who has a UTI can develop urosepsis, but certain factors can make it more likely. These factors increase the risk of urosepsis: Having surgeryWeakened immune systemHaving a kidney transplantChronic illnessRecent diagnosis of UTIHistory of recurrent UTIHistory of urosepsisUrinary tract disordersAdvanced ageDiabetesFrequent catheterizationRecent catheterizationInability to fully empty the bladderIndwelling (long-term) catheter Why Urosepsis Is More Common After Surgery There are multiple reasons why urosepsis is common after surgery. You may have a urinary catheter in place during your surgery, and it may stay in place for hours or days after your procedure. The placement of the catheter is done using a sterile technique. However, a catheter is a foreign body, which means that it is susceptible to bacterial contamination. Certain types of surgery increase the risk of infection even further. Surgery that takes place in or near the urinary tract increases the risk of a subsequent UTI or urosepsis. Surgeries such as kidney transplants, prostate surgeries, and bladder surgeries are known to increase the risk of urosepsis. UTI After Surgery Treatment If you develop a UTI or urosepsis while you have a urinary catheter in place, your catheter will likely be removed and replaced with a new one (if you still need one). The catheter that is removed may be sent to the lab to identify the type of infection. In all cases, antibiotic therapy is necessary to treat urosepsis. Blood culture and sensitivity are sometimes done to determine which antibiotics will be most effective. Most people experience improvement of signs and symptoms within 72 hours of antibiotic therapy. An ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI)may be needed to identify the source of the infection. The treatment of urosepsis is largely dependent on the severity of the illness. If you have minor symptoms, you may be effectively treated at home with antibiotics. However, urosepsis may progress to septic shock. If you have signs of this complication, which can include confusion and organ failure, you may need to be admitted to the Intensive Care Unit, Treatment can include IV antibiotics, management of blood pressure, and assisted ventilation. 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Porat A, Kesler S. Urosepsis. StatPearls. Peach BC, Garvan GJ, Garvan CS, Cimiotti JP. Risk factors for urosepsis in older adults: A systematic review. Gerontol Geriatr Med. 2016;2:2333721416638980. doi:10.1177/2333721416638980 Jiang Y, Li J, Zhang Y, et al. Clinical situations of bacteriology and prognosis in patients with urosepsis. Biomed Res Int. 2019;2019:3080827. doi:10.1155/2019/3080827 Rossaint J, Zarbock A. Pathogenesis of multiple organ failure in sepsis. Crit Rev Immunol. 2015;35(4):277-91. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269–284. doi:10.1038/nrmicro3432 Belyayeva M, Jeong JM. Acute pyelonephritis. StatPearls. Rosen JM, Klumpp DJ. Mechanisms of pain from urinary tract infection. Int J Urol. 2014;21 Suppl 1(0 1):26–32. doi:10.1111/iju.12309 Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control. 2014;3:23. doi:10.1186/2047-2994-3-23 Dreger NM, Degener S, Ahmad-Nejad P, Wöbker G, Roth S. Urosepsis--etiology, diagnosis, and treatment. Dtsch Arztebl Int. 2015;112(49):837–848. doi:10.3238/arztebl.2015.0837 Jacobsen SM, Stickler DJ, Mobley HL, Shirtliff ME. Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis. Clin Microbiol Rev. 2008;21(1):26–59. doi:10.1128/CMR.00019-07 Kalra OP, Raizada A. Approach to a patient with urosepsis. J Glob Infect Dis. 2009;1(1):57–63. doi:10.4103/0974-777X.52984 Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL. Sepsis and septic shock. Nat Rev Dis Primers. 2016;2:16045. doi:10.1038/nrdp.2016.45 Additional Reading Approach to a Patient with Urosepsis. Journal of Global Infectious Disease. By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit