Epidemiology of urinary tract infection among community-living seniors aged 50 plus: Population estimates and risk factors.

BackgroundUrinary tract infection (UTI) is common in all ages but risk factors among adults 50 and older are not well studied. One unexplored potential risk factor is constipation, a known UTI risk factor among children.ObjectiveDescribe the UTI incidence among U.S. women and men aged 50 and older and the association between constipation and other risk factors and UTI.MethodsA web interview was administered October 12-16, 2023 to U.S. adults aged 50 and older participating in a probability-based panel representative of the U.S. household population age 50 or older. The primary study outcome was self-reported healthcare provider diagnosed and treated UTI in the previous 12 months. All results were weighted to represent the U.S. household population.ResultsThe 12-month UTI incidence was 19.8% among women and 6.4% among men. Recurrence was common: 10% of women and 7% of men with a UTI had 3 more UTIs in the previous 12 months. 32% of the population reported being constipated sometimes, frequently or always. UTI incidence increased with more frequent constipation in a dose response manner among women and men. After adjusting for age, gender, having a body mass index >30 and an overnight hospital stay in the previous 12 months, those reporting sometimes being constipated were 3.69 times, and those often or always constipated were 5.48 times more likely than those never constipated to have a UTI in the previous 12 months.DiscussionThis is the first report of an association between UTI and constipation among older adults. Reducing constipation might reduce UTI incidence among older women and men.

Introduction: The aim of this study is to describe the epidemiology of urinary tract infection (UTI) in newborn infants admitted to neonatal intensive care unit (NICU) of Zagazig University. Patients and Methods: This study included 206 neonates admitted to the NICU in the period from 1/1/2010 to 1/6/2010. All neonates were subjected to detailed history taking, including prenatal history, natal history, and postnatal history, with stress on symptoms suggestive of UTI. We examined all neonates generally and locally, every case was subjected to urine analysis; suprapubic aspiration was done for all cases. The diagnosis of UTI was established by the presence of at least 5 leukocytes per high power field. Urine culture, CBC (complete blood count), blood culture, and ultrasound scanning were also done for certain cases. Results: We found 75 newborns with clinical findings suggesting UTI. We classified our neonates according to the presence of at least 5 leukocytes in urine per high power field into two groups: Group I (−ve cases) without UTI included 44 neonates (31 males and 13 females) and Group II (+ve cases) with UTI included 31 neonates (24 males and 7 females). There was no significant difference between Group I and Group II with regard to gender, age, weight, and consanguinity. The incidence of UTI in NICU was 15.05% (33/206), prevalence among suspected cases of UTI in NICU was 41.3% (33/75), and of the 39 neonates with sepsis 33 had UTI (79.5%). Of the positive cases, 77.4% were full-term neonates and 22.6% were preterm neonates. Of the 31 cases with positive urinary culture there were 18 cases (58.1%) showing Escherichia coli, and 13 cases (41.9%) were positive for Klebsiella. Conclusion: This study has highlighted the need for routine urine analysis and culture, especially in high-risk newborns and to monitor the prevalence of UTI early in life. Also routine ultrasonographic screening should be done in all newborns with UTI to save the newborns and prevent the risk of complications, which may end in renal scarring and renal failure.

Urinary tract infections (UTI) are amongst the most common bacterial infections worldwide, posing significant clinical and economic burden(1). Women are more susceptible, with nearly 50–60% of women experiencing at least one UTI during their lifetime, and 30–40% experiencing recurrent UTI (rUTI) in their lifetime(1). Cystitis, the most common UTI, remains one of the most common indications for prescribing antimicrobial treatment. However, continued use is associated with antimicrobial resistance(2), a major concern to health care and economic burden. Establishing alternative safe and effective non-antibiotic therapies for prevention of rUTI in otherwise healthy women is therefore important. Cranberry-containing products have been shown to reduce risk of UTIs(3) through inducing anti-adhesive activity against uropathogenic Escherichia coli to uroepithelial cells(4). Most clinical trials to date have tested fractions from cranberry fruit, such as juice concentrate or isolated proanthocyanidins(3). This study investigated the effect of a whole cranberry fruit powder supplement on incidence of culture-confirmed UTI (primary outcome) in women with rUTI history. A multicentre, 6-month, randomised, placebo-controlled, double-blind study enrolled 150 healthy females (18–65 years, body mass index (BMI) > 17.5-<35 kg/m2) with rUTI. rUTI was defined as ≥ 3 UTIs in the last year or at least 2 UTIs in the last 6 months, confirmed by a health professional. Women with a history of > 5 UTIs in the last 6 months were excluded. Eligible participants were randomised to 1 capsule of either 500 mg/day whole cranberry powder (Swisse High Strength Cranberry [Pacran®]) or placebo. Culture-confirmed UTIs (> 108 cfu/L) from mid-stream urine samples were assessed throughout the intervention period whenever participants experienced UTI symptoms (including dysuria, urinary frequency or urgency, fever, suprapubic pain, or macroscopic haematuria), and at baseline, 3- and 6-month clinic visits. Whole cranberry powder reduced culture-confirmed UTI risk compared to placebo by 52% (adjusted relative risk [RR] = 0.48, 95% CI = [0.26, 0.87], p = 0.01); reduced Escherichia coli UTIs (RR = 0.49, 95% CI = [0.24, 1.01], p = 0.05); incidence of UTI with urinary frequency and urgency symptomatology (RR = 0.29, 95% CI = [0.13, 0.63], p < 0.01); delayed time to first UTI episode (adjusted hazard ratio [HR] = 0.36, 95% CI = [0.18, 0.74], p = 0.01); and reduced the mean total number of UTIs per participant (adjusted incidence rate ratio [IRR] = 0.41, 95% CI = [0.21, 0.79], p = 0.01). Differences between groups in incidence of symptomatic suspected UTIs, and culture-confirmed dysuria were not detected. No safety concerns were reported. In conclusion, this study provides robust evidence that whole cranberry powder is safe to consume and reduces the incidence of culture-confirmed UTI and several other UTI-related outcomes in healthy women with rUTI history.

Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM patients

Urinary Tract Infections in Solid Organ Transplant Recipients

Since the initial scientific statement on Secondary Prevention of Coronary Heart Disease (CHD) in the Elderly was published in 2002,1 several trends have continued that make an update highly appropriate. First, the graying of the US population and those of other industrialized countries has progressed unabated because more adults are surviving into their senior years. The number of Americans aged ≥75 years was estimated at 18.6 million in 2010, representing ≈6% of the population,2 and it is expected to double by 2050. The population aged ≥85 years is growing the most rapidly, with numbers expected to reach 19.5 million by 2040. In 2008, 67% of the 811 940 cardiovascular deaths in the United States occurred in people aged ≥75 years.3 In parallel to this increase in the older adult demographic, the number of Americans with CHD has increased to an estimated 16.3 million, more than half of whom are >65 years of age.3 Similarly, 7 million have had a stroke, the incidence of which approximately doubles with successive age decades after 45 to 54 years.3 Peripheral artery disease (PAD) affects 8 to 10 million Americans, the majority of whom are >65 years of age. Between 2015 and 2030, annual US costs related to atherosclerotic cardiovascular disease (ASCVD) are projected to increase from $84.8 billion to $202 billion.3 Moreover, given that ASCVD often undermines functional capacity and independence and increases reliance on long-term care, indirect expenses related to ASCVD are also expected to increase. Thus, the need for effective secondary prevention measures in the older adult population with known ASCVD has never been greater. Notably, the 2011 American Heart Association (AHA)/American College of Cardiology Foundation (ACCF) updated guidelines for secondary prevention of CHD broadened …

Objective To monitor the catheter associated urinary tract infection in patients with severe brain injury and analyze the incidence and risk factors of urinary tract infection in hospital, so as to take preventive measures and reduce the incidence of urinary tract infection. Methods Based on the monitoring program of indwelling urinary catheter in patients with severe brain injury and combining the method of microbial monitoring and retrospective study of patients in hospital, a total of 204 catheterized patients with severe brain injury were selected and analyzed the catheter associated urinary tract infection. Results There were 12 patients with urinary tract infections, and a higher incidence of urinary tract infection in elderly, serious condition, long-term bed ridden patients and longer catheter indwelling time with severe brain injury. The incidence of urinary tract infection in patients with more invasive operations was 3.8‰. Fungus was the most common pathogenic bacteria. Conclusions Following indwelling catheter indications strictly, strengthening the aseptic management of catheter, shortening time of detaining urethral catheterization, and proper using of antibiotics are recommended as effective measures to lower the incidence of catheter associated urinary tract infection in patients with severe brain injury. Key words: Severe brain injury; Indwelling catheter; Targeted monitoring and analysis; Analysis

To investigate the incidence of urinary tract infection and analyse its risk factors among hospitalised patients with spinal cord injury. While the incidence of urinary tract infection varies widely according to the healthcare setting and patients' clinical characteristics, formal reports are limited in quantity. There has been no consensus regarding the risk factors for urinary tract infection. A retrospective descriptive study. Electronic medical records of 964 subjects between 2010-2017 were reviewed. Urinary tract infection status was examined to identify newly occurred cases. Data included demographic and clinical characteristics, hydration status and length of hospitalisation. The reporting of the study followed the EQUATOR Network's STROBE checklist. Of the sample, 31.7% had urinary tract infection (95% confidence interval: 1.288 to 1.347, p<.001). Sex, completeness of injury, type of bladder emptying, detrusor function and urethral pressure were significant factors affecting urinary tract infection. Patients who were male and those with injury classifications A, B and C had higher risk of urinary tract infection. Patients with urinary or suprapubic indwelling catheters, as well as those with areflexic detrusor combined with normotonic urethral pressure or overactive detrusor combined with normotonic urethral pressure, showed higher risk. Length of hospitalisation in patients with urinary tract infection was greater than that in uninfected patients, which implies the importance of prevention of urinary tract infection. Nurses should carefully assess risk factors to prevent urinary tract infection in patients with spinal cord injury in the acute and sub-acute stages of the disease trajectory and provide individualised nursing care. This study contributes evidence for up-to-date clinical nursing practice for the comprehensive management of urinary tract infection. This can lead to improvements in nursing care quality and patient outcomes, including length of hospitalisation.

Normal 0 false false false MicrosoftInternetExplorer4 Background: The goal of treatment in vesicoureteral reflux (VUR) is to reduce the risk of reflux-associated pyelonephritis. Medical versus surgical treatment for VUR is still controversial, with surgery successful in majority of cases. There are not enough data available in literature on long-term incidence of urinary tract infection (UTI) after reimplantation. The aim of the study was to determine the long-term outcome after reimplantation with respect to UTI, renal scarring and potential risk factors for post-reimplant UTI. Methods: It is a retrospective review of 106 consecutive cases who underwent reimplantation for primary VUR. Results: Incidence of post-reimplant UTI is 12.8%. Majority of our patients were females and showed high grade reflux. Median age at surgery was 32 months. Thirteen patients had post-reimplant UTI. Of this, 12/13 were females, 12/13 had pre-reimplant febrile UTI, 10/13 had high grade VUR, 7/13 had urge incontinence and dysfunctional voiding, and 3/13 had constipation. Only two patients showed new scarring/worsening scarring. Conclusions: It is an established fact that ureteric reimplantation is effective in preventing UTI. Some continue to develop UTI even after successful correction of VUR and it is unclear as to why it happens. Various rates of post-reimplant UTI have been quoted in literature with non-febrile UTI of 40% and febrile UTI of 14%. In our study, febrile UTI rate was 4.9% and non-febrile UTI rate was 7.9%. Post-reimplant UTI resulting in new renal scars is rare. There are some possible risk factors for recurrent UTI after reimplantation, but unfortunately only few of them are reversible (bowel bladder dysfunction). Reimplantation for VUR is a very effective treatment. Incidence of post-reimplant UTI is 12.8% with development of new scars after such UTI is rare. Several risk factors contribute to such UTI. World J Nephrol Urol. 2016;5(1):1-3 doi: http://dx.doi.org/10.14740/wjnu237w

Background: The incidence of urinary tract infections (UTIs) after radical cystectomy (RC) with urinary diversion (UD), the typical pathogens, and associated patient risk factors have not been well documented. In this study, we examined the incidence of post-op UTIs after RC to identify associated risk factors. Methods: Single-center, retrospective case series of 386 patients with bladder cancer who underwent RC with UD between 2012 and 2024. The primary objective was UTI incidence, defined by the frequency of patients with urine culture with >105 colony-forming units per high-powered field, spanning from post-op day 0 (POD0) to 90 days after discharge. Isolated pathogens were reported. Risk factors for UTIs were assessed. Results: The average age was 69 years old at surgery, and patients were predominantly male (80%). The cumulative incidence of post-op UTIs was 14%, among which 12 patients had more than one UTI. The UTI incidence was 2%, 8%, and 7% during the immediate post-op period, within 30 days, and within 31-90 days, respectively. Isolated pathogens included Escherichia coli (26%), Enterococcus faecalis (24%), Klebsiella pneumoniae (21%), and Pseudomonas species (21%). In the immediate post-op period, female sex was the only significant risk factor. At 31 to 90 days, cutaneous ureterostomy UD was the predominant risk factor for UTIs. For ileal conduit patients, those with a Wallace ureteral anastomosis were associated with UTI 31-90 days from discharge for RC. Conclusions: Our retrospective data suggests the incidence of UTIs and their causative pathogens after RC differ based on post-operative time points and vary according to different patient risk factors.

To determine the incidence of symptomatic urinary tract infections in HIV seropositive patients and to assess whether this varies with stage of disease, risk group or the use of co-trimoxazole as prophylaxis against Pneumocystis carinii pneumonia. A retrospective case note review of 175 HIV-infected patients attending The Royal London Hospital between July 1988 and December 1992 was performed. A urinary tract infection was defined as a pure culture of > or = 10(5) colony forming units in a mid-stream specimen of urine from a patient with symptoms consistent with a urinary tract infection. Urinary tract infections occurred in 10 (5.7%) of 175 patients, with an incidence of 1.49 per hundred patient years. Urinary tract infections were significantly more common in patients with AIDS or a CD4 lymphocyte count below 0.2 x 10(9)/l (or both) when compared to those without AIDS and a CD4 lymphocyte count above 0.2 x 10(9)/l (5.4 vs. 0.5 urinary tract infections per hundred patient years, p = 0.00005). Women with AIDS or a CD4 count below 0.2 x 10(9)/l (or both) had an incidence of urinary tract infection of 18.5 per hundred patient years. No significant difference was found between the incidence of urinary tract infections in those taking co-trimoxazole as Pneumocystis carinii pneumonia prophylaxis and those taking alternative or no prophylaxis (2.6 vs 6.4 per hundred patient years, p = 0.39). Urinary tract infection represents a considerable health problem amongst HIV infected patients. Our data show that urinary tract infections are more common in patients with advanced compared with early HIV infection. Cotrimoxazole, when taken by patients as prophylaxis against Pneumocystis carinii pneumonia did not appear to reduce the incidence of urinary tract infection.

Data Mining Derived Treatment Algorithms From the Electronic Medical Record Improve Theoretical Empirical Therapy for Outpatient Urinary Tract Infections

Prevalence, incidence, and risk factors of urinary tract infection among immobile inpatients in China: a prospective, multi-centre study

Febrile Urinary Tract Infections After Ureteroneocystostomy and Subureteral Injection of Dextranomer/Hyaluronic Acid for Vesicoureteral Reflux—Do Choice of Procedure and Success Matter?

Although photoselective laser vaporisation of the prostate (PVP) is a recognised alternative to transurethral resection in treating benign prostatic obstruction, there is limited data on the incidence and determinants of postoperative urinary tract infections (UTI). We assessed patients subjected to PVP, evaluating incidence and potential determinants of postoperative UTIs. Consecutive patients undergoing PVP between April 2010 and August 2018 were candidates for this retrospective cohort study. The primary outcome measure was microbiologically confirmed postoperative UTI. We fitted uni- and multi-variable Cox models to identify potential risk factors. Among the 665 included patients, 20% developed postoperative UTIs. The overall incidence rate per 100 patient-days was 0.65 (95% confidence interval [CI] 0.55-0.77). Risk factors for postoperative UTIs were end-stage renal failure (adjusted hazard ratio [aHR] = 14.10, 95% CI 2.08-64.58; p = 0.001) and presence of at least one of the following factors in the 3months preceding PVP: (i) placement of urinary catheter, (ii) bacteriuria, (iii) UTI, or (iv) antimicrobial treatment (composite aHR = 1.99, 95% CI 1.22-3.24; p < 0.001). There was no apparent association between choice or duration of antimicrobial prophylaxis and incident UTIs. Our analysis revealed a high incidence of UTIs after PVP and served to identify certain preoperative risk factors. Neither the choice of antimicrobial regimen nor its duration affected the incidence of UTIs. Prolonged antimicrobials proved to be disproportionately high, warranting further scrutiny in randomised controlled trials.