Incidence and Recurrence of Urinary Tract Infections Caused by Uropathogenic Escherichia coli: A Retrospective Cohort Study.

IF 2 Q2 UROLOGY & NEPHROLOGY Research and Reports in Urology Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.2147/RRU.S470605

Eva Raphael, Lorenzo Argante, Elisa Cinconze, Sara Nannizzi, Cheyenne Belmont, Claire F Mastrangelo, Yuan Hu Allegretti, Michele Pellegrini, Johannes E Schmidt

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Abstract

Purpose: Urinary tract infections (UTIs) are among the most common bacterial infections, with uropathogenic Escherichia coli (UPEC) as the main etiologic agent of uncomplicated UTIs (uUTIs). The prevalence of uUTis caused by organisms with antimicrobial resistance (AMR) is increasing worldwide, complexifying the disease management and increasing the risk of complications. In efforts to develop new strategies for uUTI prevention, it is imperative to understand factors associated with the occurrence of new episodes.

Patients and methods: This retrospective cohort study aimed to assess the incidence of uUTIs caused by UPEC (UPEC-uUTIs) or unknown etiology (untested uUTIs) in adults aged ≥18 years receiving care in a San Francisco healthcare system.

Results: During 2014-2019, 1087 UPEC-uUTI and 4106 untested uUTI cases were documented, of which 324 (29.8%; 95% confidence interval: 27.1%-32.6%) and 1030 (25.1%; 95% confidence interval: 23.8%-26.4%) were followed by ≥1 new episode of uUTI within 12 months. In the UPEC-uUTI cohort, male gender, diagnosis of diabetes mellitus, and prior uUTI were risk factors for new episodes of uUTI. At the time of first UPEC-uUTI diagnosis, antimicrobial prescriptions were retrieved for 41.1% of cases. When tested, AMR was most frequently reported for trimethoprim/sulfamethoxazole or trimethoprim/sulfamethoxazole prescribed with other antimicrobials.

Conclusion: Our study provides important information on the incidence and risk of repeated episodes of uUTIs, as well as on AMR related to them.

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由尿路致病性大肠杆菌引起的尿路感染的发病率和复发率：回顾性队列研究

目的：尿路感染（UTI）是最常见的细菌感染之一，尿路致病性大肠杆菌（UPEC）是无并发症尿路感染（UTI）的主要病原体。在全球范围内，由具有抗菌素耐药性（AMR）的微生物引起的尿路感染的发病率正在不断上升，使疾病管理变得更加复杂，并增加了并发症的风险。为了制定预防尿路感染的新策略，当务之急是了解与新发病相关的因素：这项回顾性队列研究旨在评估在旧金山医疗保健系统接受治疗的≥18岁成年人中由UPEC（UPEC-uUTIs）或不明病因（未经检验的uUTIs）引起的uUTIs的发病率：2014-2019年期间，共记录了1087例UPEC-UTI和4106例未经检测的UTI病例，其中324例（29.8%；95%置信区间：27.1%-32.6%）和1030例（25.1%；95%置信区间：23.8%-26.4%）在12个月内≥1次新的UTI发作。在UPEC-uUTI队列中，男性、糖尿病诊断和既往尿路感染是导致新发尿路感染的风险因素。在首次确诊UPEC-uUTI时，41.1%的病例获得了抗菌药物处方。经检测，AMR最常见于三甲双胍/磺胺甲噁唑或三甲双胍/磺胺甲噁唑与其他抗菌药物一起使用：我们的研究提供了有关尿路感染反复发作的发生率和风险以及与之相关的 AMR 的重要信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Research and Reports in Urology UROLOGY & NEPHROLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Research and Reports in Urology is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric urology in the clinic and laboratory including the following topics: Pathology, pathophysiology of urological disease Investigation and treatment of urological disease Pharmacology of drugs used for the treatment of urological disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered.