Sporadic compared to recurrent urinary tract infections: Considerations for urogynecologic patients

• Published in: Neurourology and urodynamics Vol. 39; no. 8; pp. 2186 - 2191
• Main Authors: Bradley, Megan S., Cabrera, Camila, Clark, Stephanie Glass, Sassani, Jessica, Venuti, Kristen, Ackenbom, Mary F.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.11.2020
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antimicrobial resistance; Catheterization; Cohort Studies; Cross-Sectional Studies; E coli; Escherichia coli; Escherichia coli Infections - drug therapy; Escherichia coli Infections - microbiology; Estrogens; Female; Humans; Klebsiella Infections - drug therapy; Klebsiella Infections - microbiology; Middle Aged; Recurrence; Recurrent infection; Risk factors; Urinary tract; Urinary tract infections; Urinary Tract Infections - drug therapy; Urinary Tract Infections - microbiology; Urogenital system; uropathogen; Vagina; Escherichia coli; uropathogen
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.24471

Aims To describe the uropathogens and antimicrobial resistance patterns in women with singular, sporadic urinary tract infection (UTI) vs those with recurrent UTI (rUTI) in a urogynecologic population. Methods This was a cross‐sectional analysis of women treated for a UTI by a urogynecologic provider in a 1‐year timeframe. Subjects were divided into two groups: (a) sporadic UTI—no history of rUTI and a single infection in the study timeframe and (b) rUTI—history of rUTI and ≥2 UTIs in the study timeframe. Our primary outcome was the difference in uropathogens between groups. Secondary aims were to investigate host characteristics associated with recurrent Escherichia coli infections and resistant uropathogens in the rUTI cohort. Results We had 265 women with 163 (61.5%) in the sporadic UTI group and 102 (38.5%) in the rUTI group. The most common uropathogens were E. coli (57.3%) and Klebsiella (11.7%). In the rUTI group, only 27 of 102 (26.5%) had all E. coli infections. There were differences between groups regarding age (P = .03) and proportion of neurogenic bladder (P = .01), intermittent self‐catheterization (P < .01), antibiotic suppression (P < .01), and vaginal estrogen therapy (P < .01). In the rUTI cohort, there were no risk factors that were significantly associated with recurrent E.coli UTIs and vaginal estrogen therapy was associated with a higher odds of sensitive uropathogens (adjusted odds ratio, 3.12; confidence interval, 1.28‐7.56). Conclusions In those with rUTI, it was uncommon to have recurring E. coli UTIs and consistently sensitive uropathogens. Pretreatment urine cultures are important to verify causative uropathogens in this population.