Sepsis and Urinary Tract Infections

Urinary tract infections, or UTIs, are common infections. They more frequently affect people with short urethras, including cisgender women, transgender women who have had vaginoplasty (surgery to create a vagina), and transgender men who have not had phalloplasty (surgery to create a penis). Most often, a UTI is treated quickly and effectively with antibiotics. Unfortunately, not all UTIs are treated quickly and some aren’t even identified, particularly among people who have limited or no sensation below the waist or who are unable to speak for themselves.

Untreated urinary tract infections may spread to the kidney, causing more pain and illness. It can also cause sepsis. The term urosepsis describes sepsis caused by a UTI.

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Urinary Tract Infections. 2023.

Updated November 8, 2023.


More About UTIs


A UTI is an infection in the urinary tract, which runs from your kidneys, through the ureters, the urinary bladder and out through the urethra. The infections are very common and, in general, easy to treat.

A lower UTI, the more common type, affects the lower part of the urinary tract, the urethra and urinary bladder. Infection of the urethra is called urethritis and of the bladder is called cystitis. If the kidney is infected, called pyelonephritis, this is an upper UTI, as the kidney is the highest part of the urinary tract.

A UTI can be caused by bacteria (the most common type of infection) or a fungus.


The design of the human body makes it so it isn’t hard to get a bacterial UTI, because the infection comes from outside, through the urethra. Bacteria in the genital area can enter the urethra and the urinary tract, either through wiping after going to the bathroom, sexual activity, or unsanitary conditions. Once the bacteria have entered the urethra, the body tries to fight them off, but sometimes the bacteria multiply and cause an infection.

In the case of a fungal infection, usually the fungus gets to the urinary tract through the blood stream. Those who develop this type of infection are usually ill with a disease that has compromised their immune system, such as AIDS.

In general, people with shorter urethras get more UTIs than do cisgender men and transgender men who have had a phalloplasty, surgery to create a penis and lengthen the urethra. This increases with age. Statistics show that those with shorter urethras often get more than one over their life time. Almost 20% who have had one UTI will go on to have a second.


In the early stages of a lower UTI, you may feel:

  • Sudden and extreme urges to void (pass urine)
  • Frequent urges to void
  • Burning, irritation or pain as you void
  • A feeling of not emptying your bladder completely
  • A feeling of pressure in your abdomen or lower back
  • Thick or cloudy urine – it may contain blood

As the infection progresses, you may experience:

  • Fever
  • Pain in the lower flank, part of the back where your kidneys are located
  • Nausea and vomiting
  • Fatigue

Seniors may not show any of these signs or they may be too subtle for someone else to notice. An added symptom among this age group is confusion. Often, if a senior’s behavior changes suddenly, they may have an undiagnosed UTI.


Most UTIs can be identified by symptoms and confirmed through a urine test.

If your doctor suspects that the infection has spread, you may need additional tests. These could include blood tests, scans of your kidneys, or a pelvic ultrasound.


When caught early, it is usually easy to treat a bacterial UTI effectively. After confirming that you do have an infection, you will likely get antibiotics to fight the particular bacteria causing the infection. You also should drink a lot of water, to help flush out the infection.

It is essential that you complete your full prescription, taking all the antibiotics you receive, even if you feel 100% again. Even with the symptoms gone, the bacteria will still be present for a while and you need those antibiotics to finish getting rid of them. If you do not finish your prescription, there is a very good chance that the bacteria left behind will grow again, causing another infection. And, they may become resistant to the antibiotics that you originally used.

To treat a fungal UTI, your doctor would prescribe anti-fungal medications.


In many cases, we can prevent urinary tract infections.

  • When cisgender women and transgender women wipe themselves after having a bowel movement, they should wipe from front to back, reducing the chances of stool touching the entrance of the urethra. Caregivers must do the same thing when providing intimate care.
  • After having sex, clean your genital area as the act of sex could push bacteria into the urethra.
  • If someone has a catheter, a tube that drains urine from the bladder, inserting the catheter must be in as sterile or clean an environment as is possible. As well, the urethral area must be kept clean, particularly of stool. Urinary catheters should not stay inserted for longer than necessary.

If you have frequent urinary tract infections, there are some steps you can take to try to reduce the number of infections you get. They include:

  • Drinking plenty of water every day, to help flush out your urinary tract.
  • Eat a healthy diet. Malnutrition, not consuming enough nutrients for your needs, can lower your body’s ability to fight infection.
  • Don’t hold your urine. Empty your bladder as frequently as is realistic and possible.
  • For cisgender women and transgender women, continue the wiping from front to back and cleaning well after sex.
  • Also some cisgender women find that diaphragms increase their number of UTIs, so if you are using a diaphragm, you may want to discuss an alternate method of birth control with your healthcare provider.

Related Resources

Information Guide

Click here to download your resource. Check your Downloads folder if it does not open automatically.

Stay informed! Sign up for the Sepsis Alliance Newsletter.

Please consider making a gift to support Sepsis Alliance’s work to save lives and reduce suffering by improving sepsis awareness and care. 

Information Guide

Click here to download your resource. Check your Downloads folder if it does not open automatically.

Stay informed! Sign up for the Sepsis Alliance Newsletter.

Please consider making a gift to support Sepsis Alliance’s work to save lives and reduce suffering by improving sepsis awareness and care. 

Larry W.

My husband spent 15 hours in ER at local hospital surrounded by sick covid people before being seen. Admitted with sepsis from a urinary tract infection after 20 hours of waiting. (Sepsis and UTIs) Negative PCR test. Administered morphine as pain was that bad. Loaded up with antibiotics and discharged in 36 hours or less because needed his bed for covid. Within week BP tanked, temp rose, liver and kidneys failed, heart functioning at less 20%. Doctors and specialists ignored pleas for help. Drove hour and half in horrendous rain storm to another facility begging for help. Larry coded and ... Read Full Story

Submit Your StoryView More Stories

Susan Dorsey

I’m a two time sepsis survivor. Six years ago, I had kidney stones which led to an UTI and ultimately sepsis. (Sepsis and Kidney Stones, Sepsis and Urinary Tract Infections) I was on a business trip in a new job, when I became very sick. I thought I had the flu. I managed to drive 6 hours back home after spending a long painful night in my hotel room. Went to the ER the next day, and was put into a medically induced coma to allow the doctors time to figure out the cause. Turns out it was a kidney ... Read Full Story

Submit Your StoryView More Stories

Judith Lipton

I nearly died of sepsis almost exactly one year ago, starting on May 22, 2020. I want to tell my story especially since I may be among the few people who have lived through severe encephalopathy and survived without incapacitating brain damage. I also want to educate people about the signs of sepsis, and the need for informed consent. Thanks for listening to me. Even though I am a physician myself and my husband is a professional biologist, we did not recognize the initial signs of sepsis. We should have gone to the hospital right away, as soon as I ... Read Full Story

Submit Your StoryView More Stories

Katie F.

Being a person with a chronic autoimmune disorder and an in-depth past of medical issues, I thought I understood what being very sick felt like. (Sepsis and Autoimmune Diseases) Eventually, after years of being diagnosed, I got used to having “off” days. I was finally at a point in my life where I felt “normal” and was even running in 5k races! It is very rare for people with autoimmune disorders to be able to have the energy or stamina to run in a race. I felt so free and was truly starting to enjoy life. What I didn’t know, ... Read Full Story

Submit Your StoryView More Stories

James Roberts

A little over 2 years ago it was January 12 /2019 I had gone to a friend’s for dinner and after taking off my jacket, I developed the chills. So I took some aspirin and slept it off till morning. After getting home I was still very feverish and had a very bad back ache. I spent the whole day in bed and finally ask my roommate to take me to the Emergency room where I was diagnosed with a lower lumbar strain, given some meds and sent home. That next day the pain in my back was excruciating and ... Read Full Story

Submit Your StoryView More Stories

Other Topics

Urinary Tract Infections