A spreading UTI can turn into sepsis; Kenyan study found 66% of bacteria tested were multidrug-resistant

A urinary tract infection (UTI) can become life-threatening if it spreads and the body's reaction to the infection begins to injure its own organs. That condition is called sepsis. Not every UTI goes that way, Prof Moses Obimbo, an obstetrician and gynaecologist, said, as quoted by Business Daily on 10 October. The US Centers for Disease Control and Prevention (CDC) says infections that lead to sepsis most often start in the gastrointestinal tract, the lungs, the skin or the urinary tract.

The World Health Organization (WHO) defines sepsis in its fact sheet of 3 May 2024 as "a life-threatening condition that happens when the body's immune system has an extreme response to an infection". The CDC, on a page updated on 17 August 2026, says sepsis happens when an existing infection "triggers a chain reaction throughout your body". Without fast treatment, the CDC says, sepsis can quickly lead to tissue damage, organ failure and death. WHO says bacterial infections are the usual cause, though other infections can be responsible.

A UTI starts when bacteria enter and multiply in part of the urinary system, and most begin in the bladder, Business Daily reported. If the infection spreads, it can travel from the bladder up to the kidneys, causing a kidney infection known as pyelonephritis, and bacteria can enter the bloodstream and trigger sepsis.

WHO's fact sheet cites data published in 2020 showing 48.9 million sepsis cases and 11 million sepsis-related deaths worldwide. Almost half of the cases, 20 million, were in children under 5. The CDC gives US figures: each year about 1.7 million adults develop sepsis, and at least 1 in 5 adults who develop it die during hospitalisation or are discharged to hospice.

WHO lists these common signs: fever or low temperature and shivering, confusion, difficulty breathing, clammy and sweaty skin, extreme body pain or discomfort, a high heart rate, weak pulse or low blood pressure, and low urine output. The CDC lists clammy or sweaty skin, confusion or disorientation, extreme pain or discomfort, fever, shivering or feeling very cold, a high heart rate or weak pulse, and shortness of breath. In children under 5, WHO says sepsis can cause difficulty feeding, frequent vomiting or lack of urination.

Business Daily separated the signs of a UTI from those of a kidney infection. Frequent urination, pain when urinating and pain below the belly button, sometimes with fever, need to be treated early, Obimbo said. A kidney infection can cause fever, back or side pain, vomiting and loss of appetite. Confusion, trouble breathing, faintness or collapse may signal an emergency that needs immediate hospital care, the paper reported. The CDC calls sepsis a life-threatening medical emergency and says healthcare providers should immediately evaluate and treat people who might have it.

Anyone can develop sepsis, the CDC says, and most people who develop it have at least one underlying medical condition or a recent hospitalisation. WHO's list of people at higher risk includes older people, pregnant or recently pregnant women, newborns, hospitalised patients, patients in intensive care, people with weakened immune systems, such as from HIV or cancer, and people with chronic conditions such as kidney disease or cirrhosis. Business Daily adds people with diabetes and those who have trouble emptying the bladder or a blockage in the urinary tract.

A urine test can confirm an infection, and a urine culture identifies the responsible bacteria or yeast and helps guide the choice of antibiotic, Business Daily reported. Obimbo said baking soda is not an established treatment for bacterial UTIs. The paper reported that drinking water helps hydration but does not clear a bacterial infection, and that leftover or unprescribed antibiotics can lead to inappropriate treatment. WHO says sepsis treatment is most effective when started early. It says early use of antimicrobials, medicines that treat bacteria, parasites, fungi or viruses, is essential, and low blood pressure is treated with intravenous fluids.

A study published in PLoS One in 2023 gives Kenyan data on antibiotic resistance in UTIs. Its authors include researchers at the Centre for Microbiology Research of the Kenya Medical Research Institute (KEMRI) in Nairobi. They recruited 1,898 patients with UTI-like symptoms between May 2019 and August 2020. Sites included Kenyatta National Hospital and hospitals in Kiambu, Makueni and Nanyuki. Uropathogens, the germs that cause urinary infections, were isolated from the urine samples of 1,027 participants, or 54%.

In that cross-sectional study, which surveyed patients at one point in time rather than following them, 64% of the bacteria tested were resistant to trimethoprim, 57% to sulfamethoxazole and 57% to nalidixic acid, all commonly used antibiotics. The proportion of multidrug-resistant bacteria was 66%. WHO says antimicrobial resistance is "a major factor determining clinical unresponsiveness to treatment". The study recruited patients seeking treatment for UTI-like symptoms, so its results may not reflect the community as a whole.

The authors wrote that UTI diagnosis is mainly based on dipsticks and microscopy that are "frequently inaccurate", and that proper cultures for UTI are "rarely performed" to confirm cases in many hospitals.