Epidemiology of urinary tract infections: incidence, morbidity, and economic costs
Section snippets
Symptomatic UTI
Symptomatic UTI is very common among sexually active women15 and far more common among women than men. An estimated 1 in 3 women will have at least 1 UTI diagnosed by a clinician requiring antimicrobial treatment by the age of 24 years,16 and 40% to 50% of women will experience at least 1 UTI during their lifetime16, 17, 18, 19(Figure 2). A recent random digit dialing survey of 2,000 women in the United States found that 10.8% of women >18 years reported at least 1 presumed UTI during the
Pediatrics
Approximately 3% of prepubertal girls and 1% of prepubertal boys are diagnosed with UTI5(Table 3). Many girls who do not undergo radiographic evaluation after an initial UTI experience a recurrence within 1 year,5 and girls who experience recurrent UTI are at increased risk of renal scarring,46 which then increases their risk of progressive renal disease in adulthood.47 A retrospective study recently found that 35% of boys and 32% of girls who had their first UTI at <1 year of age contracted a
Uncomplicated UTI
Acute uncomplicated UTI (cystitis) in the nonobstructed adult, nonpregnant woman is believed to be a benign illness with no long-term medical sequelae. To date, however, there are no large-scale prospective studies verifying this assumption. There are data highlighting significant short-term ramifications of acute uncomplicated UTI. Research on college women found that UTI resulted in 6.1 symptomatic days, 2.4 days of restricted activity, and 0.4 days of bed rest.30 Within 3 to 4 months of an
Financial implications of UTI
The financial implications of UTI are enormous, predominantly a result of the high incidence of UTI. Direct costs include the costs of outpatient doctor visits, antimicrobial prescriptions, and hospitalization expenses, as well as the nonmedical costs associated with travel, sick days, and morbidity. The indirect costs of lost output must also be considered. Although acute uncomplicated UTI is considered to be a benign condition with minimal long-term sequelae, it is associated with significant
Summary
UTI is the most common bacterial infection. It is generally associated with minimal morbidity except among specific subpopulations. However, there is a significant absence of data regarding its accurate incidence, factors that increase susceptibility to UTI, and the long-term medical sequelae of UTI.
There are many areas for future investigational effort. There is a need for accurate data regarding the incidence of symptomatic UTI and pyelonephritis among all populations. There is an increasing
References (92)
- et al.
Urinary tract infections complicating pregnancy
Baillieres Clin Obstet Gynaecol
(1994) - et al.
Urinary tract infections in adults with diabetes
Int J Antimicrob Agents
(2001) - et al.
Urinary tract infections in HIV disease
Int J Antimicrob Agents
(1999) Pharmacoeconomics of treating uncomplicated urinary tract infections
Int J Antimicrob Agents
(1999)- et al.
Urinary tract infectionestimated incidence and associated costs
Ann Epidemiol
(2000) - et al.
Evaluation of and antimicrobial therapy for recurrent urinary tract infections in women
Urol Clin North Am
(1998) - et al.
Urinary tract obstruction and infection in the neonate
Clin Perinatol
(1992) - et al.
A longitudinal cohort of elderly women with urinary tract infections
Maturitas
(2000) - et al.
Urinary tract infections in healthy university men
J Urol
(1993) - et al.
Effect of circumcision status on periurethral bacterial flora during the first year of life
J Pediatr
(1988)
Cohort study on circumcision of newborn boys and subsequent risk of urinary tract infection
Lancet
Hospital-acquired urinary tract infections associated with the indwelling catheter
Urol Clin North Am
A 25-year prospective mortality study in the spinal cord injured patientcomparison with the long-term living paraplegic
J Urol
Bacterial urinary tract infections in diabetes
Infect Dis Clin North Am
Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya
J Infect
Epidemiology, natural history, and management of urinary tract infections in pregnancy
Med Clin North Am
Urinary tract infections complicating pregnancy
Infect Dis Clin North Am
Urinary tract infections in pregnancy
Urol Clin North Am
Uterine contractions after antibiotic therapy for pyelonephritis in pregnancy
Am J Obstet Gynecol
Urinary tract infection during pregnancya risk factor for cerebral palsy?
J Obstet Gynecol Neonatal Nurs
Urinary infections in the elderlysymptomatic or asymptomatic?
Int J Antimicrob Agents
Clinical and economic consequences of nosocomial catheter-related bacteriuria
Am J Infect Control
Treatment of urinary tract infectionwhat’s old, what’s new, and what works
World J Urol
Management of urinary tract infections in adults
N Engl J Med
Epidemiology of urinary tract infections
Infect Med
Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments. United States, 1997
Vital Health Stat 13
Morbidity, age and sex distributionrecurrences and renal scarring in symptomatic urinary tract infection in childhood
Kidney Int Suppl
Clinical infections in the noninstitutionalized geriatric age groupmethods utilized and incidence of infections
Am J Epidemiol
Urinary tract infections in patients with spinal cord lesionstreatment and prevention
Drugs
Urinary tract infections may trigger relapse in multiple sclerosis
Axone
Incidence of symptomatic urinary tract infections in HIV seropositive patients and the use of cotrimoxazole as prophylaxis against Pneumocystis carinii pneumonia
Genitourin Med
Incidence rate of first-line symptomatic urinary tract infection in children under 6 years of age
Acta Paediatr
Risk factors for second urinary tract infection among college women
Am J Epidemiol
Management of acute dysuriaa decision analysis model of alternative strategies
Ann Intern Med
Urinary tract infections in females
Clin Infect Dis
The reported prevalence of urinary symptoms in women in one rural general practice
Br J Gen Pract
Factors associated with regular episodes of dysuria among women in one rural general practice
Br J Gen Pract
Influence of blood group on the availability of receptors for attachment of uropathogenic Escherichia coli
Infect Immun
Association of the Lewis blood group phenotype with recurrent urinary tract infections in women
N Engl J Med
Urinary tract infection in childrena review of its pathogenesis and risk factors
J R Soc Health
Urinary tract infections in infants and children
Risk factors for recurrent urinary tract infection in young women
J Infect Dis
Potential preventive strategies and therapies in urinary tract infection
World J Urol
Epidemiology of urinary tract infection. II. Diet, clothing, and urination habits
Am J Public Health
Epidemiology of urinary tract infection. I. Diaphragm use and sexual intercourse
Am J Public Health
First time urinary tract infection and sexual behavior
Epidemiology
Cited by (1441)
Biofilm-forming ability, antibiotic resistance and phylogeny of Escherichia coli isolated from extra intestinal infections of humans, dogs, and chickens
2024, Comparative Immunology, Microbiology and Infectious DiseasesPlasmid-mediated fosfomycin resistance in Escherichia coli isolates of worldwide origin
2023, Journal of Global Antimicrobial ResistanceAddressing pressures on health services in Belo Horizonte, Brazil through community-based care for poor older people: a qualitative study
2023, Lancet Regional Health - Americas